SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)
Minutes of a meeting held on 18th June, 2012.
Present: Councillor R.J. Bertin (Chairman); Councillors Mrs. M.E.J. Birch, Ms. R. Birch, Ms. K. Edmunds, K.J. Geary, Mrs. A.J. Moore, A. Parker and Ms. R. Probert.
Also present: Councillors S.C. Egan, C.P.J. Elmore, K. Hatton, N. Moore and J.W. Thomas.
43 WELCOME -
The Chairman welcomed all present to this, the first meeting of the Scrutiny Committee under his chairmanship.
44 INTRODUCTIONS -
The Director of Social Services together with the Members of his Management Team introduced themselves and provided an outline of the significant issues that were affecting their service areas.
45 APOLOGIES FOR ABSENCE -
These were received from Councillors Mrs. A.J. Preston and S.T. Wiliam.
46 APPOINTMENT OF VICE-CHAIRMAN -
RECOMMENDED - T H A T Councillor Mrs. M.E.J. Birch be appointed Vice-Chairman of the Committee for the ensuing municipal year.
47 MINUTES -
RECOMMENDED - T H A T the minutes of the meeting held on 16th April, 2012 be approved as a correct record.
48 DECLARATIONS OF INTEREST -
No declarations were received.
49 SCRUTINY FORWARD WORK PROGRAMME 2012 / 13 (DLPPHS) -
The Council’s Constitution provided that a Scrutiny Committee should determine its work programme for each financial year. The work programme also informed the Annual Report which had to be presented to all Scrutiny Committees for approval, and be reported to Full Council. The report would also include the workings of the Committees, any recommendations for future work programmes and any recommendations for amending working methods if appropriate.
The purpose of a forward work programme was to help to ensure non-Executive Councillors achieved organisation and focus in the undertaking of enquiries by the scrutiny process and to support and challenge the Council’s decision-making process and to monitor and review progress in relation to the Council’s performance management framework.
In addition to the proposed work programme items, the Scrutiny Committee was also requested to propose a topic for potential review which would be suitable for a Task and Finish exercise to be undertaken by a small group of Members and officers from the relevant Scrutiny Committee. Each Scrutiny Committee was being asked to make a proposal which would be put forward to the Scrutiny Committee Chairmen and Vice-Chairmen Group, who would consider the topics and prioritise two from those proposed from all of the five Scrutiny Committees and be undertaken during the current municipal year.
Following consideration of the report, it was
(1) T H A T the work programme for the Scrutiny Committee (Social Care and Health) for 2012/13 be confirmed as detailed in paragraphs 4 – 6 of the report.
(2) T H A T the Director of Legal, Public Protection and Housing Services be notified of the priority topic for review, to be forwarded to the Scrutiny Committee Chairmen and Vice-Chairmen Group by 22nd June, 2012.
Reasons for recommendations
(1) To confirm the Committee’s work programme for 2012/13.
(2) To permit the Scrutiny Committee Chairmen and Vice-Chairmen Group to consider and determine a priority topic for review.
50 REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL 2012 TO 30TH APRIL 2012 (DSS) -
The Committee were informed of the position in respect of revenue and capital expenditure for the period 1st April 2012 to 30th April 2012 regarding those revenue and capital budgets which formed the Committee’s remit.
The current forecast for Social Services was for a balanced revenue budget. In addition to increased demand for services, there was pressure on the Directorate to achieve its savings target for 2012/13.
Children and Young People’s Services – there continued to be considerable pressure on the Children’s placement budget. Any increase in the number of children becoming looked after by the Council over the year could significant impact on the service.
Adult Services – there was continuing pressure on the Community Care Packages budget. This budget was extremely volatile and could be adversely affected by outside influences such as last year’s introduction of the First Steps Initiative by the Welsh Government which capped charging for non-residential services to £50 per week. It had been previously reported that the impact of the £50 cap was approximately £650k. Since that date, there had been continuous growth in the number of clients, and consequently the estimated full year impact was now £1.4m. There was potential that this could rise further.
The Social Services Directorate was committed to achieving a balanced budget in 2012/13. The Social Services Budget Programme Plan had been updated to demonstrate the steps to be undertaken to attain the savings targets set for the Directorate. The multi disciplinary project team and project board which had been set up to oversee the plan would further develop it and oversee and facilitate its delivery.
The monitoring report for the Capital Programme showed actual expenditure spent for the month of April 2012 and was matched by a similar figure in the profile to date column, thereby showing no variances.
Appendix 2 to the report did not include requests for unspent committed expenditure to be slipped from 2011/12 into 2012/13. A request for this slippage would be included in the Closing Down report to be presented to a future Cabinet.
RECOMMENDED – T H A T the position with regard to the 2012/13 revenue and capital monitoring be noted.
Reason for recommendation
That Members are aware of the position with regard to the 2012/13 revenue and capital monitoring relevant to this Scrutiny Committee.
51 SELF ASSESSMENT AND IMPROVEMENT (DSS) -
Committee received an outline of a new framework for understanding and promoting organisational effectiveness within the Social Services Directorate.
During the period 2008 to 2010, the Welsh Government put in place a new approach to performance improvement in social care and to whole authority social services inspection and review. Key elements of accountability for performance management were transferred from the national centre back to Council Members and relevant officers.
Local Authorities have made good use of the new opportunities. For example, they have developed a comprehensive framework to underpin production of the annual report which Directors of Social Services must publish, describing the effectiveness of social care services in their authority and plans for improvement. Notwithstanding this progress, there remained a clear risk that the process could be reversed, especially given some recent policy changes which emphasise the need for greater centralisation and control. It was felt important, therefore, that local government continued to demonstrate a real commitment to developing an effective and coherent framework for social services when dealing with issues of performance evaluation, benchmarking against best practice and generating positive change in performance standards.
Reports from Care and Social Services Inspectorate Wales (CSSIW) and other external evaluators confirmed that the Vale of Glamorgan was well regarded in this respect. The Council made very good use of performance management systems, including the Director’s Annual Report, the annual performance review by the Social Services Inspectorate, individual inspections and review, performance indicators, the Ffynnon system and the annual complaints report. There were also a number of staff accountability systems and these operated to a high standard.
The Council needed to continue building on these strong foundations and therefore, officers had been working to define the key factors that characterised an effective Social Services Directorate and to place these within a framework that would secure ongoing improvement. The work was intended to complement other initiatives, such as production of the three year Change Plan. There would be a range of specific benefits,
it would help structure some of the self-assessment exercises that underpinned the Council’s performance improvement framework, including the statutory requirement for the Director to produce an annual report
additionally, important stakeholders such as members of Scrutiny Committees, would have available explicit and clear statements about what they should expect from the Directorate and how they should evaluate current performance
staff would benefit from a coherent set of ideas about what matters most and where change efforts should be focused.
This was not an area where a clear consensus existed. Evaluating comparative effectiveness and deciding what factors were most important in making the difference were not easy tasks. One complicating feature was the fact that social services had an exceptionally broad remit: supporting people through periods of difficulty and vulnerability, protecting children and adults from abuse or neglect, promoting social inclusion and independence, and acting within local government as champion for those who are most vulnerable and at risk.
Even if definitive answers were not available, there was some helpful evidence. For example, in “Reviewing Social Services in Wales 1998-2008 – Learning from the Journey”, CSSIW and the Wales Audit Office analysed what had been learned about organisational effectiveness from the joint review programmes. Additionally, to assist CSSIW in their annual performance evaluation of Council social services functions, a taxonomy or “performance descriptors” had been developed.
Managers in the Social Services Directorate had used the material on hand to produce a self-assessment document, set out in Appendix 1 to the report and the Star Performance Chart, set out in Appendix 2.
It was intended that these documents would be used in a number of ways:
to provide a clear direction for staff
to assist in production of the Director’s Annual Report, service plans and team business plans
to help staff when they are engaged in decision-making within the Directorate
to inform the Council’s systems for performance management
to be a part of the induction pack for new staff.
RECOMMENDED – T H A T the contents of the new framework, and its use on a pilot basis during 2012-13 be noted.
Reason for decision
To ensure that Scrutiny Committee is aware of the new framework, to help provide the Social Services Directorate with coherent direction and to improve performance.
52 CONSULTATION ON THE SOCIAL SERVICES (WALES) BILL (DSS) -
Scrutiny Committee were informed of the Council’s response to a consultation document by the Welsh Government setting out the broad scope of its legislative proposals for the Social Services (Wales) Bill.
On 12th March 2012, the Welsh Government published a consultation document setting out the broad scope of its legislative proposals for the Social Services (Wales) Bill in the following areas:
maintaining and enhancing the wellbeing of people in need
giving citizens a stronger voice and real control
ensuring a strong national direction and local accountability for delivery, safeguarding and protection
regulation and inspection
adoption and transitions for disabled children and young people.
The period of consultation ended on 1st June.
The Bill was intended to provide the Welsh Government with the legislative basis for taking forward “Sustainable Social Services for Wales – A Framework for Action”, its strategic plan for putting social services on a sound footing as announced last year.
The strategy made it explicit that wholesale transformation and structural change were not necessary. Steps to reshape social services were required however, as a response to factors such as changes in family structures, demography, expectations about service user control, more fragmented communities and the impact of issues such as substance misuse.
Social services and social care were facing real and unsustainable increases in demand. The numbers of looked after children and those on the child protection register were growing. The number of people registered with local authorities in Wales as having a learning disability were increasing. There was a rising number of older people with complex care needs who could benefit from support and whose support needs were extensive. Moreover, the financial outlook was exceptionally difficult because of profound changes in public sector finances and resources.
The strategy document concludes that, faced with this context, the choice was either retrenchment or renewal.
The strategy introduced eight priorities for action to support an emphasis on renewal. In summary, these priorities were:
a strong national purpose and expectation, and clear accountability for delivery
a national outcomes framework
citizen centred services
a confident and competent workforce
safeguarding and promoting the wellbeing of citizens
a new improved framework.
Much of the programme outlined in Sustainable Social Services for Wales could be achieved without altering current legislation and the Bill was intended to cover areas where this was not the case. However, accordingly to the Welsh Government, the Bill would also “provide - for the first time - a coherent Welsh legal framework for social services, based on the principles we hold dear in Wales”. It would bring together the duties of local authorities and their partners to safeguard and promote the wellbeing of people and their functions in relation to social care, key processes of social work practice and the regulation and inspection of bodies / professionals who provided care services. The overall intention was to:
simplify the diverse legislative framework that currently regulated social care in Wales
make access to services much easier and more understandable to those who need them
give people a strong voice and real control.
The Bill would cover social care services for both children and adults and, “as far as it is possible and appropriate, integrate the arrangements for both of these groups so that social care services are provided on the basis of need and not of age”.
From the broad scope outline published by the Welsh Government, the proposed Bill was likely to be an exceptionally complex piece of legislation. The Bill would bring together, into a single unified legal framework:
the duties of local authorities and their partners to safeguard and promote the wellbeing of people and their functions in relation to social care
key processes of social work practice
the regulation and inspection of bodies / professionals who provide care services.
It was agreed that the individual response from the Vale of Glamorgan Council at this time would deal primarily with the broad thrust of the proposed Bill and a copy of the response was attached at Appendix 2 to the report. The WLGA and ADSS Cymru had provided a detailed response to each section and a copy of these were attached at Appendices 3 and 4 to the report.
(1) T H A T the Vale of Glamorgan Council’s response to the consultation document be noted.
(2) T H A T all Members of the Scrutiny Committee (Social Care and Health) receive a presentation on the Social Services (Wales) Bill prior to the next scheduled meeting of the Committee.
Reasons for recommendations
(1) To ensure that the views of the Council in respect of the proposed legislation are represented properly in the consultation process and while the Bill is undergoing legislative scrutiny.
(2) To further inform the Members of the Scrutiny Committee.
53 IMPACT OF THE SOCIAL CARE CHARGES (WALES) MEASURE 2010 AND THE FIRST STEPS TO IMPROVEMENT REQUIREMENTS (DSS AND DR) -
Committee were updated regarding the 2011/12 financial impact of implementing the new Welsh Government policy in respect of charging for non residential social care services.
The Social Care Charges (Wales) Measure 2010 gave local authorities in Wales a discretionary power to impose a reasonable charge upon adult recipients of non residential social care services. The Welsh Government was provided with authority to determine the maximum charge any service user could be asked to pay.
There followed a period of dialogue between the Welsh Government and local authorities to examine the likely consequences of introducing a charging cap, especially regarding reimbursement for lost income. In January 2011, before implementation of a proposed £50 cap, local authorities were asked to provide information regarding the number of people in receipt of non residential social care for a particular week of their choice. This Council chose a week in August 2010, when there were 930 service users, 497 of whom were paying charges, of whom 148 were identified as being charged more than £50 per week. Calculations had been made on the basis of 2009 charging policies and it was identified that the potential income foregone would be £208k.
The Welsh Government was aware that this exercise did not include any provision for the possible impact of any cap on numbers of service users or their take up of services; these factors were not built into the model used. The total for all local authorities was £10.1m. and the Welsh Government decided to allocate this via the Revenue Support Grant (RSG) with the expectation that the actual impact for each local authority would be monitored closely.
The First Steps to Improvement requirements imposing the £50 cap were introduced very quickly, in advance of pending National Assembly elections. They came into effect on 11th April 2011 and the relevant Regulations were only published after the event. The allocation of funding was based on the Relative Needs Formula and, to meet the income foregone or additional cost incurred as a result of implementing the new policy, the Vale of Glamorgan received £373k. in the RSG for 2011/12.
It was the opinion of officers in the Council that using the Relative Needs Formula to distribute the First Steps to Improvement grant within the RSG was flawed. It contained indicators of need under three main categories: Main Client Group, Population Dispersion and Deprivation. However, it was unlikely that the Deprivation factor would have a bearing on the impact of the £50 cap, given that the highest impact on local authorities was likely to result from the emergence of more affluent service users who previously would have funded care themselves.
The Welsh Government had been monitoring the impact of the new legislation and the current Regulations. An initial half-year monitoring report, involving a very detailed analysis, was submitted by all local authorities in November 2011 which estimated that the additional annual costs to this Council were £1.396m. Understandably, given the scale of the increase, the Welsh Government asked officers in the Vale of Glamorgan to undertake further work with the assistance of Internal Audit to verify the figures. This resulted in a small number of alterations to the claim form and a revised figure to meet the costs of implementation that was approximately £650k. more than the grant received.
It appeared likely that this Council would continue to experience disproportionate losses in income when compared to other Welsh local authorities. There were a number of factors that explained this divergence:
Before April 2011, like a small number of other local authorities, the Vale of Glamorgan did not have a cap on how much an individual could be asked to contribute towards the cost of their care in cases where they either failed to disclose their finances or where a financial assessment revealed their savings / investments exceeded the limit of £22k.
There were a high number of individuals funding their case, either because they were financially assessed as being able to do so or because they chose not to declare their income to the Council. As a result, the Vale of Glamorgan had seen a marked increase in the number of people who had requested support from Social Services because their contribution was capped at £50 per week. Analysis showed that the number of service users had increased from 141 in August 2010 to 335 in February 2012. Of these 335 individuals, 184 were new clients and it was estimated that some 86% of them would have been self funding or not willing to disclose their income under the previous policy.
The Council had a duty under legislation to notify any person who received a chargeable service or who may receive a service inviting them to undergo a financial assessment to qualify for the maximum contribution of £50. The Social Services Directorate had acted very promptly to reassess existing cases where people were making contributions of over and above £50 towards their care were and, therefore, the difference was also a loss of income to the Council.
Because a high proportion of service users had previously sought social care services privately, the Vale of Glamorgan had relatively low numbers of older people for whom it organised services. Hence, there was an element of “catch up” now.
To date, the Welsh Government had not agreed to address the shortfall in funding. Officials had said that they would consider the end year monitoring returns from local authorities and Ministers could then consider what, if any, changes were required to the arrangements already put in place.
The Cabinet considered this matter on 11th June and asked to receive further updates on progress made in resolving issues with the Welsh Government.
(1) T H A T the contents of the report be noted.
(2) T H A T Scrutiny Committee continues to receive regular updates on progress made in resolving issues with the Welsh Government.
Reason for recommendations
(1&2) To ensure that Scrutiny Committee is aware of the implications for the Council’s budget and the actions taken in response.