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HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE

 

Minutes of a meeting held on 16th January, 2017.

 

Present:  Councillor R.L. Traherne (Chairman); Councillor Dr. I.J. Johnson (Vice-Chairman); Councillors Ms. J. Aviet, R.J. Bertin, Ms. R. Birch, S.C. Egan, E. Hacker, H.C. Hamilton and J.W. Thomas.

 

Also present:  Councillors Ms. B.E. Brooks and N. Moore.

 

 

675     APOLOGIES FOR ABSENCE –

 

These were received from Councillor S.T. Wiliam.

 

 

676     DECLARATIONS OF INTEREST –

 

No declarations were received.

 

 

677     MINUTES –

 

RECOMMENDED –

 

(1)       T H A T the minutes of the meeting held on 22nd November, 2016 be approved as a correct record, subject to it being noted, that under those present, Councillor Ms. R. F. Birch should read Councillor Ms. R. Birch

 

(2)       T H A T the minutes of the meeting held on 8th December, 2016 be approved as a correct record, subject to it being noted: That under Agenda Item No. 7, reference from Cabinet, Reshaping Services – Review of Meals on Wheels Service, the Committee, prior to having agreed to support the implementation of Option 4 (cease the internal service and to signpost to alternatives, including a social enterprise), also considered a Member’s Motion for an alternative option to be proposed to Cabinet.  The Motion, having been seconded, was voted upon and did not receive the support of the Committee.

 

 

678     UPDATE ON THE WORK UNDERTAKEN BY PUBLIC HEALTH WALES, BY DR. SIAN GRIFFITHS, CONSULTANT IN PUBLIC HEALTH MEDICINE –

 

The Committee welcomed Dr. Sian Griffiths, Consultant in Public Health Medicine, who had been invited to provide an overview of the work undertaken by Public Health Wales. 

 

Dr. Griffiths began by referring to some of the key determinants when it came to assessing public health: 

  • Life expectancy within the Vale for both males and females had increased although those people living in deprived areas of the Vale were still comparatively disadvantaged.  There were similar inequalities in respect of healthy living expectancy, with an average 20 year gap for men. 
  • Smoking – whilst overall rates were declining across Wales, in areas of high deprivation the rate of smoking was much higher.  In the Vale of Glamorgan areas of central Barry showed a rate as high as 29% while in the Western Vale the rate was as low as 17%.  A number of factors could explain the high rate, including access to cheaper tobacco.
  • Physical activity – the rate of people taking part in the minimum of 150 minutes of exercise per week had flatlined across both Wales and the Vale of Glamorgan. 
  • The rate of adults who reported eating five or more portions of fruit or vegetables a day showed a small reduction over the past four years and was an area of concern. 
  • The rate of adults of working age with a healthy weight was below 50% and more people in the Vale are now overweight.
  • The percentage of adults drinking above the recommended guidelines was currently at over 40% in the Vale, which was above the Welsh average.  In particular, older people in the Vale were a key area of concern.  

Dr. Griffiths also referred to a number of partnership public health documents which illustrated the work that was ongoing at present.  These included the following: 

  • Public Health Integrated Medium Term Plan
  • Tobacco Free Cardiff and Vale Strategy and Action Plan
  • Cardiff and Vale Healthy Weight Framework
  • Cardiff and Vale Physical Activity Action Plan
  • Cardiff and Vale Eating Well Action Plan
  • Cardiff and Vale of Glamorgan Alcohol Working Group Action Plan. 

In terms of some examples of success, Dr. Griffiths outlined that there were a number of programmes ongoing in relation to tobacco.  In the Vale of Glamorgan, three schools had signed up to the Smoke Free School Gates Scheme with another three schools looking at the Just Be programme.  Dr. Griffiths also outlined the key work that was undertaken through the National Exercise Referral Scheme and also initiatives around food and alcohol awareness for older people.  Other important initiatives included the Otago Fall Prevention Programme and also the Making Every Contact Count Scheme, which was around ensuring that professionals from all partnership agencies were involved in providing consistent public health messages and support to individuals.

 

In terms of how things could be done better, Dr. Griffiths outlined that there should be stronger links in relation to urban healthy planning, active travel, promotion of urban and rural green spaces as a means to improve physical and mental wellbeing.  She outlined that greater support was needed for the Vale Food Charter, commonly known as Food Vale, and also there was a need for more efficient joint working in which information and priorities for each agency was shared on a more regular basis. 

 

The Chairman stated that legislation around smoking had been a relative success and queried whether there was anything to be learned in regard to promotion of healthy living and weight loss.  In reply, Dr. Griffiths stated that work was being undertaken around influencing people to reduce the level of sugar in their diets and advertisement campaigns were being designed to focus on children and young people.  She also outlined that UK Government support could be stronger and that the Welsh Government had limited areas of power in this area.  A key aspect was lobbying for better food labelling and a focus on sugar intake.

 

A Committee Member stated that the inequality in the life expectancy figures were very stark and he queried as to what level of the population would be following  all of the healthy living guidelines.  In reply, Dr. Griffiths stated that this was very complex.  Although some people would be aware of all the healthy lifestyle choices, at present only 6% of the population chose to follow all of them.  She outlined that this showed how difficult it was to stick to the guidelines.  She added that the term Lifestyle Choices was commonly used but, in many cases, choice would not be available, particularly in deprived areas where healthy food was not so easily accessible or affordable.

 

A Member referred to challenges being experienced in some of the deprived areas of the Vale and he asked whether there was anything that local Councillors could do to help with the Public Health campaigns.  In reply Dr. Griffiths advised that there was an Action Plan in place to ensure that more actions were focused on the more deprived areas.  Work such as tackling the level of smoking was being progressed on an individual Ward basis and she stated that the Food Charter was a key strategic document. 

 

In reply to a query regarding the level of staff being given the flu immunisation jab, Dr. Griffiths stated that the Local Health Board had been successful in encouraging staff to have the vaccinations.  Her colleague from Public Health Wales, Dr. Tom Porter, was leading on this.

 

The Chairman queried the percentage of the NHS budget that was spent on Public Health and he asked whether the Welsh Government Minister was minded to increase spending or the profile of Public Health.  Dr. Griffiths stated that, as a percentage of overall spending, the overall budget on Public Health was small but that Welsh Government Ministers were well focused on public health.  She added that the Well-being of Future Generations Act was seen as world leading, with public health written right through it as a document.  In that regard, Wales was well placed. 

 

A Committee Member asked for clarification regarding healthy eating.  The Member queried whether food priced at a modest level was more of an issue than people’s willingness to cook healthy meals.  The Member also referred to the fact that food packaging and labelling had been in place for over a decade and had not seemed to have improved the situation.  The Member queried how Local Government and other public services could persuade people to live a healthier lifestyle.  In reply, Dr. Griffiths stated that this was a key issue.  Packaging was not an easy thing to get right as there would be some people who would be well aware of the issues and would still choose not to follow the recommended guidelines.  She added that time could be an issue for a number of demographic groups and she cited the example of people on zero hours contracts who would not have enough time or confidence to prepare a healthy meal.  Therefore, there was a need for a multi-faceted approach in order to support people to make the right lifestyle choices. 

 

In reply to a Member’s query regarding the meningitis immunisation programme, Dr. Griffiths advised that the Meningitis B Vaccination was being provided to new born babies.  She added that she was not sure of the catch up programme for older children.

 

Having thanked Dr. Griffiths for her input, the Committee

 

RECOMMENDED – T H A T the presentation by Public Health Wales be referred to Cabinet for its action as appropriate and in particular to highlight the following areas for improvement: 

  • Stronger links around urban healthy planning, active travel, promotion of urban and rural green spaces as a means to improve physical and mental well-being.
  • Greater support for the Vale Food Charter “Food Vale”.
  • Efficient joint working and regular sharing of information and priorities.

Reason for recommendation

 

To highlight to Cabinet that there were specific areas for improvement that could be progressed in the Vale of Glamorgan in regard to healthy living lifestyle choices.

 

 

679     WALES AUDIT OFFICE REPORT ON DELAYED TRANSFERS OF CARE – CARDIFF AND VALE HEALTH AND SOCIAL CARE COMMUNITY (DSS) –

 

For this item, the Committee welcomed Mrs. Urvisha Perez, Performance Auditor for the Wales Audit Office, and Judith Hill, Head of Integrated Care for the Cardiff and Vale University Health Board (UHB).  The purpose of the report was to highlight the outcomes of a Wales Audit Office (WAO) review into Delayed Transfers of Care in the Cardiff and Vale of Glamorgan region.

 

Mrs. Perez advised that the review had been carried out between March and June 2016.  The review had highlighted the following: 

  • The partnership working arrangements for Cardiff and the Vale had improved the rate of Delayed Transfers of Care;
  • There was evidence of good progress in relation to integration and joint working;
  • There were strong governance structures in place;
  • Partners jointly owned delayed transfers of care and collective action was being taken to tackle the issues;
  • Performance was widely and regularly reported across the partnership ensuring a sustained focus on improvement. 

The WAO had made two recommendations.  The first one was to address the findings of the Delivery Unit’s discharge planning audit, either by developing a separate action plan or by incorporating actions into existing service improvement action plans.  The second recommendation related to the Intermediate Care Fund (ICF) and to explore ways of mainstream services being funded through the ICF to ensure that services remained resilient.

 

The Chairman then asked the Head of Integrated Care to provide an update on the current position.  She advised that the direction of travel was still positive and that the level of Delayed Transfers of Care had reduced to 61 across the region with 21 in the Vale of Glamorgan.  She stated that this was really positive when compared to where the Health Board was back in February 2015 when 150 cases had been delayed.  She added that it was also fair to say that there were still some significant issues such as the capacity of Elderly, Mentally and Infirm (EMI) care and nursing homes and the struggle in placing individuals into these homes as well as the availability of domiciliary care for complex cases.  She also explained that it was difficult to determine how the Health Board measured the flow of patients across the whole system on a regular basis. 

 

The Head of Integrated Care also advised that there were a number of improvement programmes currently being progressed with the aim to speed up the hospital discharge process.  She referred to the Unscheduled Care and Improvement Programme which was looking at the process from the front door through to the moment a patient was ready to be discharged.  In addition, there would be a weekly multi-agency meeting to discuss patients declared ready for discharge and to look at the complexities of cases.  There was also a lot of scrutinising of decisions taken around patient discharge and whether these could have been taken in a quicker timeframe. The key element was in relation to streamlining the process.  She referred to the strong relationships between the Health Board and Vale of Glamorgan Council which she deemed to be excellent and the close co-operation that existed with the Discharge Teams.  In summary, she added that she was still somewhat anxious about this month’s Delayed Transfers of Care figures and she reiterated her concerns in relation to domiciliary care and the provision of EMI placements.

 

The Chairman queried whether the challenges around care homes were in relation to capacity or was it as a result of family choice.  In reply, the Head of Integrated Care stated that it was a combination of both.  As there was a lack of capacity, this meant that there was not the choice available so families were reluctant to accept a choice that they did not want to make.  Further to these comments, the Director of Social Services stated that the issue of residential home provision was somewhat different for the Vale of Glamorgan (and Cardiff) because community hospitals were not used and so there was potentially greater reliance on residential and nursing care.  The question for him, as Director, was whether Health Board savings on acute services should be reinvested into community health and social care.  He added that a debate across Wales was needed on the preferred model of care.

 

A Committee Member stated that, from his perspective, the Vale of Glamorgan had been proactive and that improvements had been made in the level of hospital discharges.  However, there was a need to look beyond statistics as these were all individuals who were not always appropriately placed and suffered as a consequence.  There was a need to scrutinise very closely how long individuals were staying in hospital.  He added that a year was too long and that this was something that the WAO may need to look at.  The Member also raised the issue of pooled budgets and queried whether enough work was currently being carried out prior to February 2018 when the Cardiff and Vale Health Board would have to implement pooled budgets.  In reply, the Interim Head of Business Management and Innovation stated that the Joint Commissioning Board was currently looking at this and so work was being progressed.

 

In reply to a question regarding the possible use of Barry Hospital, the Head of Integrated Care stated that the Unscheduled Care and Improvement Programme was still at an early stage.  It was looking at alternative provision and service areas which were not being maximised.  It was too early, therefore, to comment on the best use of Barry Hospital, however, nothing had been ruled out.

 

A Committee Member commented that, in terms of performance, the report had highlighted that the rate of Delayed Transfers of Care in Cardiff and the Vale remained the second highest in Wales.   The Member queried whether any good practice had been picked up from other Health Boards and were there any specific problems that needed to be addressed.  In reply, Mrs. Perez advised that no other Health Board area was looked at during the review, although some case studies of good practice were included in the report.  She also added that it was important to consider that the patient flow for the Cardiff and Vale Health Board was the second largest in Wales.

 

Further to these comments, the Head of Integrated Care stated that in terms of numbers, the Health Board was not satisfied with current performance.  Patients could not be discharged if they were at risk of harm and the key element of the Improvement Programme was to streamline the process and to establish any aspects that were preventing hospital discharges.  With regard to the Delayed Transfers of Care performance indicator, she stated that it was important to remember that this was an on-a-day census and so it was very difficult to capture this information for an entire month. 

 

A Committee Member queried whether challenges in the domiciliary care sector were impacting on the level of Delayed Transfers of Care.  The Head of Integrated Care stated that domiciliary care was a significant issue for the Health Board and Local Authorities, particularly in relation to the fragility of the market and the pressure on providers to remain cost effective.  She also highlighted that packages of care were becoming more complex and some domiciliary care providers struggled with the level of demand.  Therefore, the situation needed to be closely monitored, including how the Health Board assessed patients and how best to provide complex domiciliary care packages.

 

RECOMMENDED –

 

(1)       T H A T the Wales Audit Office review in respect of Delayed Transfers of Care in the Cardiff and Vale Health and Social Care Community be noted.

 

(2)       T H A T the report and Review be referred to Cabinet for its consideration.

 

Reasons for recommendations

 

(1)       To keep the Scrutiny Committee informed and to ensure that Members of the Committee are fully aware of the findings and conclusions of the review.

 

(2)       To ensure that Cabinet has sight of the Review and is able to consider areas of improvement.

 

 

680     REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL TO 30TH NOVEMBER 2016 (DSS) –

 

The Operational Manager for Accountancy presented the report, the purpose of which was to advise the Scrutiny Committee of the position in respect of revenue and capital expenditure for the period 1st April to 30th November, 2016. 

 

In setting the Social Services budget for 2016/17, the use of £970,000 from the Social Services Fund was approved.

 

The projected outturn for the Social Services Directorate was an adverse variance of £600,000 when compared to the amended budget.

 

A table and graph setting out the variance between profiled budget and actual expenditure to date and the projected position at year end were attached at Appendix 1 to the report.

 

Children and Young People's Services – It was projected that this service would outturn with an underspend of £400,000.  Work had been ongoing to ensure that children were placed in the most appropriate and cost effective placements.  This had included the Council’s success in significantly reducing the number of children placed in residential care, from an average of 23 in 2014/15 to a current average of 10.  It should however be noted that the number of Looked After Children had increased during the course of the year, placing considerable pressure on the Council’s in-house fostering resources and increasing the Council’s reliance on independent fostering placements.  Given this pressure and the complexity of some of these children, the outturn position could fluctuate with a change in the number of Looked After Children and / or their need for independent fostering or residential placements.

 

Adult Services – It was projected that the Community Care Package budget could outturn with a variance of up to £1m by year end.  This budget was extremely volatile and had been adversely affected this year by the increase in the cost of packages commissioned as a result of the introduction of the National Living Wage, the continued pressure on the budget from demographic growth and clients having increasingly complex needs.  The final outturn was, however, difficult to predict.  The increase in fee levels was above the level of inflation provided for within the budget.

 

The annual deferred income budget for 2016/17 had been set at £747,000 and, as at 30th November, 2016, income received to date was £211,000 over-recovered.  It was therefore being projected that this budget would outturn at £100,000 over-recovered by year-end and this favourable variance was included as part of the projected overspend for care packages.

 

The service would strive to manage growing demand and try to mitigate this position and some initiatives may be funded via regional grants in the current financial year.  It was proposed that any shortfall at year end was funded from the Social Services Legislative Changes fund to cover the shortfall.  Committee would be provided with further details during the course of the year.

 

Leisure Services – It was anticipated that this service would achieve a breakeven position at year end.  Employee costs within Grounds Maintenance were projected to be under budget due to vacant posts, however, this had been offset by increased supplies and services costs. Transport costs were projected to be £80,000 over budget due to high repair costs early in the financial year, however, Grounds Maintenance were currently reviewing the level of vehicles they required and had identified those that were surplus to requirements.

 

In relation to the Social Services Programme, the Directorate was currently required to find savings totalling £2.257m by the end of 2019/20 and this target was analysed by year in the following table.  The surplus shown and the savings brought forward figures were as a result of the foster carer recruitment project, which was being developed in addition to the required savings targets.  This surplus could be used to mitigate any increase in savings to be found in future years.

 

Year

Savings Required

£000

Savings Identified

£000

In Year Surplus/ (Shortfall)

£000

Cumulative Surplus/     (Shortfall)

£000

Savings Brought Forward

 

110

110

110

2016/17

1,002

1,078

76

186

2017/18

605

605

0

186

2018/19

320

320

0

186

2019/20

330

330

0

186

TOTAL

2,257

2,443

 

 

 

Within Adult Services, £100,000 of the full year saving generated from the Hafod Homes transfer had been offset against the £300,000 saving for Residential Services.  Currently, there were no other approved plans in place to find the remaining £200,000 of this saving.  Further consideration would have to be given to the way in which the saving could be fully achieved during the year.  With regard to the Care Package Budget Reduction, while there was significant pressure on this budget, schemes had been put in place to deliver savings in this area by transferring domiciliary care clients to direct payments, by putting in place additional reablement capacity and by establishing a review team.

 

Appendix 3 to the report detailed financial progress on the Capital Programme as at 30th November, 2016.

 

Community Centres Works – A net contribution of £7,500 was received from a Community Centre in order to facilitate works to a boiler system and it would therefore be requested that the Capital Programme be increased to reflect this.

 

Leisure Centre – The Leisure Centre floor replacement and changing room works were expected to commence in March 2016 and therefore, it would be requested that £134,000 be brought forward from the allocated 2017/18 Capital Programme budget of £1,912,000 to fund flooring works (£70,000) and Changing Room works at Penarth Leisure Centre (£40,000) and Barry Leisure Centre (£24,000).

 

Wordsworth Park – Local residents, school pupils and their parents, and others with an interest in the future of Wordsworth Park, were invited to have their say on the proposed improvements.  A consultation ran from Monday, 19th September until Monday, 31st October, 2016.  The consultation results had been considered, and the Council’s Principal Landscape Architect was now preparing a brief based upon the consultation responses and would shortly be undertaking a tendering exercise.  It was likely that the chosen contractor would be appointed early next financial year.  Improvements to the park would be implemented prior to September 2017 and therefore slippage of £70,000 would be requested.

 

Parks and Grounds Maintenance Asset Renewal – A virement of £18,000 would be requested from a resulting underspend on the Barry Island Community Centre roof renewal scheme which was part of the Parks and Grounds Asset Renewal budget to the Community Centres Works scheme.  This was in order to progress further Community Centre asset renewal projects in 2016/17.

 

Parks and Ground Maintenance Asset Renewal – Following a review of expenditure within the asset renewal budget for Parks and Ground Maintenance, it was considered that expenditure on licences should be treated as revenue expenditure rather than capital.  The Capital Programme would therefore be reduced by £12,000 and the costs be reported through revenue.

 

Appendix 4 to the report provided non-financial information on capital construction schemes.  From this Appendix, it could be seen that most of the previous year's schemes had now commenced and some were complete.  Start dates had also been provided for new schemes for this financial year and these would be monitoring closely to identify if capital schemes start to slip and to identify if further action needed to be taken.

 

In reply to a Member’s query regarding the impact on the budget as a result of the changes to the Deprivation of Liberty Safeguards, the Head of Adult Services stated that this was having a very significant effect and was a large cost pressure within the budget.  This was an ongoing challenge for the Council and a limited amount of financial support had been provided by Welsh Government.

 

The Committee asked for an update regarding the Welsh Government’s cap on the weekly charge for domiciliary care services and also in regard to the Intermediate Care Fund.  In reply, the Operational Manager for Accountancy stated that the proposed increase on the cap to £70 a week could equate to an additional £250,000 extra income for the Council each year.  With regard to the proposed £10m Welsh Government increase for Social Care, she advised that this would equate to an additional 3% of the Council’s budget.  In relation to this, the Director stated that in addition, Welsh Government had indicated that an extra £25m had been allocated for Social Services across Wales, although the specific detail for any of this extra money had yet to be provided.

 

The Chairman queried progress in relation to the Colcot Pitches and St. Paul’s Church Capital Programme schemes.  In reply, the Operational Manager for Leisure advised that it was likely that some of the work for the Colcot Pitches would be carried forward into the next financial year.  With regard to St. Paul’s Church, he advised that this would be the subject of report to Cabinet in the near future that would detail possible options.

 

In reply to a question regarding financial savings relating to the Learning Disability Day Services, the Head of Adult Services advised that the £30,000 savings already identified was as a result of a member of staff leaving the service.  He also added that savings in the back office function for this service would not be huge and so there was a need to look at how effective the Learning Disability Day Service strategy had been.

 

A Committee Member asked for an update in respect of the Independent Living Fund (ILF).  The Head of Adult Services advised that the ILF was continuing and that the Strategic Leadership Group was looking at the scheme and how the money could be spent.

 

The Chairman queried the level of winter pressures that had been experienced this year.  In reply, the Head of Adult Services stated that it was too early to tell whether this was any better or worse than previous years.  He also added that the budget monitoring process was extremely complex and that, as the end of year approached, the Council would have a better picture on the final budget position. 

 

RECOMMENDED –

 

(1)       T H A T the position with regard to the 2016/17 revenue and capital monitoring be noted.

 

(2)       T H A T progress made in delivering the Social Services Budget Programme be noted and be referred to Cabinet for consideration.

 

Reasons for recommendations

 

(1)       To ensure that Members are aware of the position with regard to the 2016/17 revenue and capital monitoring relevant to this Scrutiny Committee.

 

(2)       That Members are aware of the progress made to date on the Social Services Budget Programme.

 

           

681     COMMUNITY MENTAL HEALTH SERVICES (DSS) –

 

The Head of Adult Services introduced the report that provided an overview of how mental health services in the Vale operated.  For this item, the Head of Adult Services was joined by the Social Care Lead for Mental Health.

 

In summarising the report, the Head of Adult Services referred to the additional work being undertaken by community support workers around meeting the healthy living lifestyle needs of adults with a mental health issue.  The Head of Adult Services also outlined the challenges as a result of the condition and suitability of the Amy Evans building which accommodates the Central Vale Community Mental Health Team.  He also highlighted the impact on community resources as a result of legislative changes which was increasing demand.  In addition, he referred to joint management arrangements for the social work element of community mental health teams and the joint post with Cardiff Council.  It had been identified that there had been clear benefits but also some problems which meant that this arrangements would be brought to an end at least in the medium term.  Therefore, there was a proposal to create an operational post for mental health and learning disability services with sole responsibility for the Vale of Glamorgan. 

 

In respect of the condition of the Amy Evans building, a Committee Member queried the specific issues.  The Social Care Lead for Mental Health stated that some remedial work was being progressed, such as repairs to the roof, but there were also issues such as the need for new toilet facilities, windows and confidential meeting rooms.  The Committee agreed that the report should be referred to Cabinet to highlight the concerns of the Committee around the condition and suitability of the Amy Evans building.

 

The Chairman, referring to a previous report provided to the Committee which outlined that one of the three Community Mental Health Teams was under significantly more pressure than the other two, queried whether plans were being progressed to improve this.  In reply, the Head of Adult Services stated that this was the main purpose of the review of the community mental health services being undertaken, but this needed to be progressed in a quicker timeframe.  The Plan was to reorganise the working arrangements of the three teams in order to meet the level of demand. 

 

A Committee Member stated that the report indicated that the level of people who would experience mental health issues would be in their thousands and he queried how this related to the current referral rate, which was around 120 each month.  In reply, the Head of Adult Services stated that primary health services would receive the majority of referrals which would be handled by General Practitioners.  The Community Mental Health Teams would only deal with the more serious and complex mental health cases. 

 

In outlining the referral process, the Social Care Lead for Mental Health advised the Committee that the majority of referrals would come through a General Practitioner, although all Agencies would be able to make a referral and individuals could also make self-referrals.  When a referral was received, this would go through a screening process to ensure that it met National Institute for Health and Clinical Excellence (NICE) guidelines.  If accepted, referrals would be allocated on the basis of need and two professionals would then be assigned in order to carry out an assessment.

 

A Committee Member queried the impact of library closures, which could possibly increase the number of people with mental health problems who were socially isolated.  In reply, the Social Care Lead for Mental Health explained that the issue of patients becoming isolated was a growing problem and the Third Sector was being invited to undertake more preventative work.   

 

RECOMMENDED –

 

(1)       T H A T the contents of the report be noted.

 

(2)       T H A T the report be referred to Cabinet to highlight the Committee’s grave concern regarding the condition and unsuitability of the Amy Evans building, which was clearly not fit for purpose.

 

Reasons for recommendations

 

(1)       To inform the Scrutiny Committee of developments in Community Mental Health Services in the Vale of Glamorgan.

 

(2)       In order to outline the Committee’s concerns regarding the condition and suitability of the Amy Evans building.

 

 

682     CARDIFF AND THE VALE OF GLAMORGAN POPULATION NEEDS ASSESSMENT (DSS) –

 

The Committee welcomed Dr. Tom Porter, Consultant in Public Health Medicine.  Dr. Porter had been invited in order to provide an overview of the draft Population Needs Assessment for the Vale of Glamorgan and Cardiff and to ensure that the Committee could contribute to the process and agree the future priorities for the service.

 

The Social Services and Well-being (Wales) Act 2014 introduced a duty on Local Authorities and Local Health Boards to jointly prepare and publish an assessment of the care and support needs of the population, including carers who need support.  A draft report of the assessment for the Vale of Glamorgan and Cardiff region was attached at Appendix 1 to the report.  The final report must be formally signed off by both Councils and the Cardiff and Vale University Health Board and published before April 2017.

 

The Act and associated statutory guidance require that the report be presented under a number of themed headings.  The draft report included information on the methods used to undertake the assessment, as well as information on care and support needs, assets, and prevention needs under each topic area.

 

The assessment should inform local area plans which would be prepared during the period April 2017 – March 2018, as well as other statutory planning processes.  Initial recommendations from professionals on priorities for these plans and areas where changes may be required in care or support arrangements were included in each chapter.  These would be subject to review and refinement during 2017/18 as part of the area planning process and turned into detailed descriptions of the range and level of services required to meet the needs identified.

 

The assessment was undertaken at the same time as the Well-being Assessments in each Local Authority area, required under the Well-being of Future Generations (Wales) Act 2015.  Wherever possible, evidence from the assessments had been shared and the assessments informed each other.

 

Specific findings for each topic were given in the relevant chapter and summarised in the Executive Summary.

 

At the start of Section B, caveats were set out about the way in which parts of the assessment should be interpreted.  These included the fact that, for the Vale of Glamorgan, there was insufficient detail on some topics at present.  More information was being sought to ensure that the report was balanced across the two Local Authority areas.

 

A number of overarching care and support needs emerged which were identified in more than one topic area.  These were presented in section B13 of the draft report.  The most common were: 

  • easy access to information about support and services available;
  • timely access to mental health services, including diagnosis and counselling;
  • timely access to other services;
  • social isolation;
  • building healthy relationships including emotional and mental health, sexual health;
  • practical life skills, including financial skills (for all ages);
  • support for young and adult carers;
  • respite for young and adult carers;
  • enabling smoother transitions from children to adult services;
  • maintaining and increasing provision and sustainability of community services and support;
  • healthy lifestyles including tobacco use, alcohol, diet and physical activity;
  • transport to facilitate access to services; and
  • healthy environment and accessible built environment. 

The Chairman stated that a lot of information within the Population Needs Assessment was already known to the Committee and the Council’s services and he queried whether there was anything startling or new to report.   Dr. Porter stated that he hoped that most of the information within the Population Needs Assessment was already known and the key aim was trying to collate all information into one place and document.  An important aspect of the Population Needs Assessment was about creating prominence, particularly in relation to the overarching care and support needs that were highlighted above and within paragraph 8 of the covering report. 

 

The Chairman queried the next stage of the process and whether actions would be progressed on a regional or Local Authority basis.  In reply, Dr. Porter stated that the next stage would be the scoping of recommendations for the Area Plan, which would be regional but with some focus at a local level.  Further to his comments, the Director of Social Services stated that in terms of public health, there was a need to focus on the most disadvantaged areas and those where significant inequality issues were identified.  Therefore, there should be different approaches for different parts of the Vale and he stated that regional and generic solutions were not always best.  He added that there was a need to balance out and consider how specific parts of the population were targeted.

 

A Committee Member stated that an important element for him related to war veterans, it was of note the Vale of Glamorgan had the highest number in Wales.  He queried how the Population Needs Assessment would fit into the work already being carried out and how would any subsequent recommendations be resourced.  Dr. Porter explained that, in terms of going forward, there were two key areas.  The first would be the approach taken by the Regional Partnership Board and secondly, the implementation of the Area Plan.  What the Population Needs had highlighted was the need to bring a more joined up approach to working and also the requirement to take into account the Council’s Corporate Plan and the need to redesign how services operated. 

 

In response to a Member’s queries regarding the amount of detail on air pollution and whether Brexit had been factored in, Dr. Porter stated that the Population Needs Assessment was a summary document and so there was a limit to the amount of detail that could be provided.  With regard to Brexit, he advised Members that this had not been factored in and that the Population Needs Assessment was based on current need and would be updated on a mid-term and five year basis.

 

RECOMMENDED – T H A T the contents of the draft Population Needs Assessment report be noted.

 

Reason for recommendation

 

Having considered the Population Needs Assessment for the Vale of Glamorgan and Cardiff.