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SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)

 

Minutes of a meeting held on 3rd September, 2012.

 

Present:  Councillor R.J. Bertin (Chairman); Councillor Mrs. M.E.J. Birch (Vice-Chairman); Councillors Ms. K. Edmunds, K.J. Geary, A. Parker, Ms. R.F. Probert and S.T. Wiliam.

 

 

Also present:  Councillor S.C. Egan.

 

 

255     APOLOGIES FOR ABSENCE -

 

These were received from Councillors Ms. R. Birch, Mrs. A.J. Moore and Mrs. A.J. Preston.

 

 

256     MINUTES -

 

RECOMMENDED - T H A T the minutes of the meeting held on 16th July, 2012 be approved as a correct record.

 

 

257     DECLARATIONS OF INTEREST -

 

No declarations were received.

 

 

258     IMPROVEMENT PLAN 2012/13 (MD) -

 

Committee received the draft Improvement Plan 2012/13, which contained performance and improvement information for all Directorates and Corporate Plan priorities. 

 

Committee were advised that the Part 2 Improvement Plan (circulated prior to the meeting and available on the Council's website) was a document primarily looking back over 2011/12.  The improvement objectives contained within it had been agreed in May 2011.  Information contained within the Plan was based on departmental Service Plans which were discussed by the Committee in May 2012.  It also contained key performance measures along with targets and actions for 2012/13 as agreed by the Scrutiny Committee in July 2012.  Where available, it contained Welsh average performance for benchmarking purposes. 

 

The performance information would be used by the Wales Audit Office to assess the Council's capacity to improve, and therefore was of critical importance to the reputation of the Council. 

 

It was reported that the Plan was substantially complete although further minor amendments would be required following changes to performance information provided by the Local Government Data Unit and from proof reading.  This information would be included prior to the final draft being presented to Cabinet in October.

 

Having considered the report and draft Plan, it was

 

RECOMMENDED - T H A T the Improvement Plan for 2012/13 be endorsed and referred to Cabinet and Full Council.

 

Reason for recommendation

 

To ensure that actions are taken to improve the performance of the Council.

 

 

259     REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL 2012 TO 31ST JULY 2012 (DSS) -

 

Committee were advised of the position in respect of revenue and capital expenditure for the period 1st April 2012 to 31st July 2012 regarding those revenue and capital budgets which formed the Committee's remit. 

 

Although early in the financial year, the current forecast for Social Services was for a balanced budget.

 

Children and Young People’s Services - there continued to be pressure on the Children's Placement budget, specifically in respect of children with especially complex needs.  There was also pressure on the budget for accommodation costs for homeless young people.  Any increase in the number of children becoming looked after by the Council over the year could significantly 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 has been previously reported that the impact of this cap was approximately £1.4m.  The impact would continue to be monitored as the year progressed and discussions would continue with the Welsh Government regarding the issue.  Another issue to affect the year end position would be the 2012/13 fee set up in respect of personal care costs for residents placed by the Council in residential and nursing homes provided by the independent sector.

 

Appendix 2 to the report detailed financial progress on the Capital Programme as at 31st July, 2012.

 

Having considered the report, it was

 

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.

 

 

260     ANNUAL REPORT OF THE DIRECTOR OF SOCIAL SERVICES 2011 / 2012 - CHALLENGE VERSION (DSS) -

 

Committee received a copy of the Director's Annual Report in order that Members could contribute to the challenge process and agree the future priorities for the service. 

 

The Director of Social Services was required by the Welsh Government to produce an annual report on the effectiveness of social care services in the Vale of Glamorgan and on the Council's plans for improvement.  This provided an opportunity for the Director to provide people in the Vale with a rounded picture of social services based on evidence such as what users and carers say, key performance indicators and measurements of progress against the overall goals of the Council.

 

This year, each Head of Service has also provided an annual report, including an assessment of how well the service was doing in different service areas and priority objectives for improvement in 2012 / 13.  All the reports represented the views of the Director and other managers in Social Services and were not Council policy at this stage.

 

A challenge version of the Director's report was attached at Appendix 1 to the report and the three reports by the Heads of Service were attached at Appendix 2.  Circulating challenge versions was intended to allow key stakeholders an opportunity to comment and make observations before the report was finalised, ensuring that it accurately reflected the position of social services. 

 

The report had been presented to Committee to provide Elected Members with an opportunity to contribute their views. 

 

The final report would be presented to Cabinet and circulated widely.  It would be made available via the Council's website. 

 

Councillor Mrs. Birch stated that she had found the document interesting and was pleased that it had been written in plain English. 

 

Councillor Ms. Probert felt that the wording of the sentence commencing “People at particular risk .....” in Paragraph 40(c) of Appendix 1 to the report should be amended. 

 

Following a wide ranging discussion on the contents of the report, it was

 

RECOMMENDED -

 

(1)       T H A T the Director's Annual Report for 2011 / 12 – Challenge Version be noted.

 

(2)       T H A T the comments made by Members during the course of discussions on the document be noted.

 

Reason for recommendations

 

(1&2)  To provide Elected Members with an opportunity to contribute to the challenge process for the Director’s Annual Report 2011 / 12.

 

 

261     TELECARE SERVICES (DSS) –

 

Committee were updated on the development of assistive technology services such as Telecare within the Vale of Glamorgan and on proposals for a more regional approach to providing a community alarm and Telecare call monitoring service.

 

Telecare was a means whereby care and support could be provided to people through the use of telecommunications and technology in their own homes.  The objectives for Telecare services in the Vale were to:

 

·         allow people to maintain or retain their autonomy

·         provide them with greater flexibility and choice in the care and support they receive

·         help them to live safely at home

·         help to reable people following a crisis such as a fall or hospital admission

·         improve service user confidence and mobility

·         promote healthy lifestyles

·         improve and make safe the living environment

·         enable service users to maintain their dignity and self respect.

 

Telecare services in the Vale were known as TeleV and TeleV+.  TeleV was a self referral service and offered the service user a choice of packages aimed primarily at safety or security.  The users of the service did not have to be clients of social services.  The safety package included smoke and heat extreme detectors linked wirelessly to the Lifeline telephone, enabling alarm messages to be conveyed automatically to the 24 hour monitoring centre in the event of an emergency.  The security package replaced some of the environmental sensors with sensors to detect intruders, to reduce the likelihood of distraction burglary and doorstep crime.

 

The TeleV+ service was tailored to the individual needs of more vulnerable groups who were in receipt of health services or who had been assessed as requiring community care services.  The target groups for TeleV+ included:

 

·         older people who were in hospital and who may need support and reablement to enable them to return home and live independently

·         people with poor mobility who were at risk of suffering a fall and being left on the ground for a long period of time

·         people with long term conditions or chronic diseases who were likely to be admitted to hospital on a recurrent basis as a result of exacerbations of their disease

·         people who had a cognitive impairment which made it unsafe for them to live alone or without continuous supervision

·         adults with learning disabilities so that they can maximise their independence.

 

There had been a number of developments in the TeleV and TeleV+ service in the past year. 

 

The number of TeleV installations had increased and 486 packages were now in place, compared with 136 in March 2009. 

 

There had also been an increase in the number of TeleV+ packages, with 61 now in place.  Initially, such packages were quite simple, using standard equipment and focusing particularly on alerts in respect of falls.  A temporary Telecare Specialist Advisor post had enabled the service to provide better support to the social work teams with regard to Telecare options.  As a result, more complex packages were being supported. 

 

Work with partners was becoming well established.  Care and Repair installed equipment on behalf of the Council and their staff received regular updates with regard to the equipment available.  Additionally, there was ongoing work with Atal Y Fro, to pilot a service that supported families to break the cycle of domestic violence.

 

Pilot schemes had been introduced with health services, including:

 

·         the use of bed occupancy monitors in Baruc Ward, Barry Hospital

·         equipping a bungalow at Rookwood Hospital with Telecare equipment, to facilitate a stepped discharge for some patients.

 

On 19th January 2011, Cabinet had endorsed a number of improvement projects proposed by South East Wales Improvement Collaborative (SEWIC).  This collaborative programme was designed to provide the ten local authorities with an additional means of delivering service modernisation and cost effectiveness, supported by options appraisals and business cases.  One of the work streams was the development of a more collective approach to the provision of assistive technology.  The project aimed to examine the collaborative benefit and opportunity to plan, develop, commission and deliver assistive technology services on a partnership basis.  It had now developed a business case consolidation paper, exploring the merits of possible regional options for providing a community alarm and Telecare call monitoring service.  This business case was being reviewed by officers and would be the subject of a further report to Scrutiny Committee.

 

During discussions on the Service, Members enquired how many people had upgraded to the TeleV+ system and were advised that this information would be provided separately. 

 

Another suggestion made was that the availability of the service be advertised in doctors’ surgeries. 

 

RECOMMENDED –

 

(1)       T H A T the work being undertaken to deliver Telecare services within the Vale of Glamorgan be noted.

 

(2)       T H A T the potential development by the South East Wales Improvement Collaborative (SEWIC) of a regional Community Alarm, Telecare and Telehealth monitoring centre be noted.

 

(3)       T H A T the proposed business case put forward by SEWIC for developing such a centre, to be examined further by officers and reported to Scrutiny at a later date, be noted.

 

(4)       T H A T the Council aspire to increase and promote the takeup of people with Telecare.

 

(5)       T H A T Committee receive a further progress report in 12 months on the takeup of the service and the impact on the Council’s budget.

 

Reason for recommendations

 

(1-5)        To ensure that Elected Members exercise effective oversight of this key service for promoting independence and enabling vulnerable people to remain in their own homes.

 

 

262     CARERS STRATEGIES (WALES) MEASURE 2010: CARERS INFORMATION AND CONSULTATION STRATEGY FOR THE VALE OF GLAMORGAN AND CARDIFF (DSS) –

 

Committee were informed about the way in which the Social Services Directorate was responding to principal requirements of the Carers Strategies (Wales) Measure 2010 within the timescales set by the Welsh Government. 

 

In January 2012, the Carers Strategies (Wales) Measure 2010 came into force.  This legislation placed a duty on Local Health Boards to lead on preparing, publishing and implementing a three year Carers Information and Consultation Strategy.  The Cardiff and Vale University Health Board was the lead organisation for this geographical area and they had been working closely with this Council, Cardiff Council, carers and the third sector to develop the Strategy. 

 

To comply with the requirements of the Measure, the Strategy must set out in detail how the statutory organisations would provide information and advice which was appropriate to carers and assist carers in carrying out their caring role effectively.  There was also a requirement to make clear how organisations would work together to ensure that carers were consulted before they decide what services were to be provided to a carer or the person being cared for.  The draft Strategy must be submitted to the relevant Welsh Ministers by 31st October 2012. 

 

Developing the Strategy had provided an additional impetus for all three statutory organisations to work together in supporting carers.  This joint approach would ensure that carers were identified as early as possible, and received the support, information and involvement that they needed in a timely and seamless way. 

 

The Strategy would set out how:

 

·         health services would identify carers as early as possible

·         information and guidance would be provided to carers to assist them in carrying out their caring role effectively

·         carers would be consulted and involved in decisions affecting them and those for whom they cared.

 

Across the Vale and Cardiff, a wide range of support services were provided, including:

 

·         involvement of carers in the assessment of and care planning for the cared for person

·         undertaking a carer’s needs assessment and providing services to carers following the assessment

·         funding third sector organisations to provide services to carers

·         holding information events and signposting carers to services that may assist them

·         offering manual handling training and short courses of therapies.

 

Five linked programmes were identified to assist in the implementation of the Strategy.  These would:

 

·         develop a partnership framework to ensure that the three organisations worked together to support carers

·         raise awareness of carers, their role and needs to ensure that everyone involved was “carer aware”

·         implement an education and training framework, to ensure that the training needs of healthcare staff and carers was met

·         develop carers pathways to identify the information, support and consultation that carers needed throughout their time as a carer

·         provide an information framework to ensure that all carers were provided with appropriate information at all stages of their caring pathway.

 

RECOMMENDED –

 

(1)       T H A T the proposed Carers Information and Consultation Strategy 2012 – 15 be noted.

 

(2)       T H A T the further examination of the Strategy by officers of the likely costs that might accrue from implementation and of the outcome from an Equality Impact Assessment which would be undertaken by the lead body (the Cardiff and Vale University Health Board) be agreed.

 

(3)       T H A T, subject to a satisfactory result from recommendation (2) above, delegated authority be given to the Director of Social Services in consultation with the Cabinet Member for Adult Services to endorse the Strategy for submission to the Welsh Government.

 

Reason for recommendations

 

(1-3)    To ensure that Elected Members exercise effective oversight of this key service development and that carers receive the support they require.

 

 

263     1ST QUARTER PERFORMANCE MONITORING REPORTS (DSS) –

 

The Business Management and Innovation, Adult Services and Children and Young People’s Services 1st quarter performance monitoring reports were presented for the Committee’s consideration. 

 

In view of the fact that explanations were contained within the detail of the reports, it was

 

RECOMMENDED – T H A T the 1st Quarter Performance Reports be noted.

 

Reason for recommendation

 

In order for the Committee to exercise effective scrutiny of the services.

 

 

264     SICKNESS ABSENCE UPDATE – APRIL 2011 TO MARCH 2012 (MD AND DSS) –

 

Committee received the sickness information for the Social Services Directorate for the period April 2011 to March 2012 and received an update on the progress made in delivering and responding to sickness absence management arrangements within the Directorate. 

 

Absence figures, targets and outturn for Social Services and corporately for the Council (excluding schools) for the period April 2011 to March 2012 were shown as follows:

 

 

Corporate Annual Target

2010/2011 & 2011/2012

Corporate Actual against Target -

April 2011 - March 2012

Social Services Total for period

April 2011 to March 2012  

Average lost days/shifts per FTE

9.0 days

8.74 days*

11.55 days

Percentage of lost time by FTE

No targets set at this level.

3.3%

4.4%

Total Days Lost

Corporate = 18808.86 days

Social Services = 5481.24 days

    

    *       Excluding Schools.

 

Committee also received a breakdown against individual services within the Directorate along with financial year outturn figures in respect of the previous year:

 

Social Services Directorate

Average lost days by FTE - April 2011 to March 2012

Target for the full year

Comparison for the same period last year - April 2010 to March 2011

Children & Young People

5.73

10.4

8.63

Adult Services

10.52

13.4

15.06

Business Management & Innovation (inc Director's Office)

19.95*

5.4

9.98*

Total

11.55

11.8

12.99

 

*           It should be noted that the significant increase within this Service can be attributed to the transfer of Residential Services staff from Adult Services to the Business Management and Innovation Service.

 

Compared with the same period last year, there was an overall decrease in the level of absence of 0.6% within the Directorate.  It was anticipated that this trend would continue throughout the year.

 

The split between short term and long term was 32% and 68% respectively, compared with 23% short and 77% for the same period in the previous financial year.  The top three reasons for absence during the latest period were stress, muscular skeletal and viral infections.  Support arrangements existed for staff, including access to the Employee Counselling, Occupational Health, Revive Office Therapy Services and Chiropractor Service.

 

Social Services remained a predominantly “front line service”.  As a consequence, the availability of alternative options (e.g. home working or light duties) to support staff was problematic.  Therefore, the focus remained on the early intervention through Occupational Health referral to assist a speedy return as well as identifying, where appropriate, reasonable adaptations. 

 

There remained a continued requirement on all managers to continue complying with their responsibilities as set out within the Corporate Management of Attendance Policy.

 

Members of the Committee commended the improvement in absence figures, although the view was expressed that the complexities of some of the IT systems in use within the Directorate may be a contributory factor to the level of stress related absence.

 

The Director of Social Services advised that, in his opinion, there was unnecessary bureaucracy in the way Social Services are required to carry out assessment and case management work.  Use of these systems is a national requirement and so they cannot be changed.  However, there is increasing recognition that reform is needed and the Vale would be keen to pilot new approaches as part of the Welsh Government’s 10 year strategy “Sustainable Social Services: A Framework for Action”.  Any request of Scrutiny Committee to the Welsh Government via Cabinet asking to reduce the levels of unnecessary bureaucracy would be of assistance.

 

RECOMMENDED –

 

(1)       T H A T the report and the reduced levels of sickness absence within the Directorate be noted and that further reports be received in relation to this matter.

 

(2)       T H A T Cabinet be requested to write to the Welsh Government requesting that the Strategy to reduce unnecessary bureaucracy be accelerated.

 

Reasons for recommendations

 

(1)       Members have previously asked to receive, on a routine basis, reports confirming that the Social Services Directorate was contributing effectively to the corporate aims and objectives in respect of the Management of Attendance Policy and achieving higher levels of attendance by staff.

 

(2)       To accelerate the reduction in unnecessary bureaucracy.

 

 

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