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SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)

 

Minutes of a meeting held on 8th October, 2012.

 

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

 

Also present:  Councillors Mrs. V.M. Hartrey and J.W. Thomas.

 

 

392     APOLOGY FOR ABSENCE -

 

This was received from Councillor Mrs. A.J. Preston.

 

 

393     DECLARATIONS OF INTEREST -

 

Councillor R.J. Bertin declared an interest in Agenda Item No. 5, Revenue and Capital Monitoring for the period 1st April, 2012 to 31st August, 2012 and Update on the Social Services Budget Programme in that he was the Chairman of the Gibbonsdown Community Centre.

 

Councillor Bertin vacated the room whilst matters concerning Gibbonsdown Community Centre were under consideration, and at such times, Councillor Mrs. M.E.J. Birch (Vice-Chairman) took the Chair.

 

 

394     MINUTES -

 

RECOMMENDED - T H A T the minutes of the meeting held on 3rd September, 2012 be approved as a correct record.

 

 

395     WYN CAMPAIGN -

 

Members were advised that the proposed presentation relating to the Wyn Campaign Phase 2 had been deferred.

 

 

396     REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL, 2012 TO 31ST AUGUST, 2012 AND UPDATE ON THE SOCIAL SERVICES BUDGET PROGRAMME (DSS) -

 

Committee were advised of the position in respect of revenue and capital expenditure for the period 1st April, 2012 to 31st August, 2012 regarding those revenue and capital budgets within the Committee's remit, and were also requested to agree to a change to the Capital Programme. 

 

Committee also received an update on the progress made in delivering the Social Services Budget Programme.

 

The current forecast for Social Services was for a balanced revenue budget. 

 

Children and Young People’s Services - there continued to be pressure on the Children's Placement Budget, specifically from children with especially complex needs.  There was also pressure on the budget in respect of accommodation costs for homeless young people.  Any increase in the number of children becoming looked after by the Council over the year could have a 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-essential services to £50 per week.  The impact of this change would continue to be monitored as the year progressed and discussions with the Welsh Government regarding the issue would continue.  Another issue to affect the year end position would be the 2012/13 fee set in respect of personal care costs for residents placed by the Council in residential and nursing homes provided by the independent sector.  A further pressure on the service was the need to achieve the savings targets, set as part of the Social Services Budget Programme.

 

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

 

Day Care Re-configuration, Rondel House - works were needed to transfer the servicing of the kitchens at Rondel House to a new electricity supply.  Works had been anticipated to cost £50,000 more than the existing budget.  It was proposed to fund £25,000 of the costs from a contribution from revenue budgets whilst it was proposed that the balance be transferred from the approved Capital Budget for the upgrade of Rhoose Road Residential Home, where it had been determined that it was not feasible to carry out extension work within the budget available due to complications with drainage. 

 

Gibbonsdown Community Centre - under the Economy and Environment Scrutiny Committee's remit, there was a proposed capital scheme to refurbish the Gibbonsdown Children's Centre.  It had been proposed that the scheme be funded partly from the Flying Start Capital Grant and also from the Barry Regeneration Area (BRA) Grant.  Neither grant offers had yet been formally received by the Council, although the BRA Grant had initially been approved for the Gibbonsdown Children's Centre, who had originally applied for the grant.  When grant offers had formally been received, Committee would be advised, and an amendment to the Capital Programme would be requested. 

 

Cabinet, on 30th July, 2012 had requested that further updates on progress with the Social Services Budget Programme be reported on a monthly basis. 

 

In order to meet corporate savings targets and to bring the budget back in line following the projected overspend in 2012/13, the Directorate was currently required to find savings totalling £8.5m by the end of 2015/16.

 

Progress in identifying these savings had been made, and the table included within the report showed the current position.  Sufficient savings had been identified to meet the targets for 2012/13 and 2013/14 but there still remained £3.9m to be identified for 2014/15 and 2015/16.  The Director of Social Services had been asked to finalise actions for these periods no later than January 2013.

 

The report to Cabinet on 30th July, 2012 had identified a shortfall in the savings of £4.5m.  Since this date, further savings of £588,000 had been identified by re-assessing saving targets for existing projects and by identifying new projects but, subject to approval, other projects would not be pursued. 

 

It was proposed that the following new projects be progressed:

  • Residential Care Provision Tender (£50,000) - the Council would review the way in which it purchased residential provision for children and young people.
  • Supported Lodgings (£20,000) - arrangements for the provision of supported lodgings for young people would be reviewed.
  • Team Configuration (£20,000) - team budgets within the Children’s and Young People Service would be reviewed.

It was proposed that the following projects be not progressed further:

  • Meals on Wheels (£10,000) - the relatively small level of saving was not commensurate with the high level of resource required to realise the changes.
  • Learning Disabilities Day Services (£500,000) - the initial report from an external review of this service identified limited potential to make savings.
  • Business Manager Local Safeguarding Children’s Board Council Funding (£27,000) - this saving would be achieved as part of the Business Management and Innovation Managed Budget Reduction Project and it had been transferred to that project.

The table included within paragraph 20 of the report showed the breakdown of the currently identified savings by Service Area.

 

The Social Services Directorate was committed to achieving a balanced budget.  The Corporate Programme Board and Project Teams overseeing the Plan would continue to develop it further and ensure delivery and progress.  Progress updates would continue to be reported on a monthly basis as part of the overall financial monitoring report for the Directorate.

 

Discussions ensued on the contents of the report, and the recommendations contained therein. 

 

RECOMMENDED -

 

(1)       T H A T the position with regard to the 2012/13 Revenue and Capital Monitoring be noted, and that the proposed amendment to the Day Care Re-Configuration Capital Scheme at Rondel House to increase the budget by £50,000 (funded from a transfer of £25,000 from the Rhoose Road Capital Budget and £25,000 contribution from revenue) be endorsed and referred to Cabinet for approval.

 

(Councillor Ms. R.F. Probert stated that she did not know enough about the proposed changes to the Capital Programme to express a view.)

 

(2)       T H A T the progress made on the Social Services Budget Programme be endorsed and referred to Cabinet for approval.

 

Reasons for recommendations

 

(1)       That Scrutiny Members are aware of the position with regard to the 2012/13 Revenue and Capital Monitoring, and Cabinet approves the proposed amendment to the Capital Programme.

 

(2)       That Scrutiny and Cabinet Members are aware of the progress made to date on the Social Services Budget Programme and endorse the proposed amendments.

 

 

397     UPDATE REPORT: MANAGING ALLEGATIONS OF PROFESSIONAL ABUSE - COMPLIANCE WITH PART IV OF THE ALL WALES CHILD PROTECTION PROCEDURES (DSS) -

 

Committee received a report which gave an assurance that the Council complies with the requirements of the All Wales Child Protection Procedures as they relate to managing allegations of professional abuse.

 

The Vale of Glamorgan Council took seriously its responsibility for complying with Part IV of the All Wales Child Protection Procedures 2008, which dealt specifically with the handling of professional abuse cases.  The Council was able to demonstrate that allegations involving professionals were pursued rigorously. 

 

Allegations of abuse may involve all professionals, employees and volunteers working for or accredited by public, voluntary, private, agency, place of worship or faith organisation or independent contractor, whose work brought them into contact with children.  Allegations of abuse may be made against an individual employee in either their private life or their working capacity. 

 

Where these allegations involved Council staff, serious matters that may constitute gross misconduct were supported by suspension of the employee(s), subject to investigation.  In all instances, such issues were determined by a Head of Service or above.  Any allegation of potential abuse brought to the attention of Human Resources was referred immediately to the Safeguarding Unit in Social Services, and advice obtained.  If allegations were made against education and school staff, discussions always took place between the designated officers for safeguarding in Social Services and the Learning and Skills Directorate.  When taking forward action that potentially involved suspending, dismissing or terminating the contract of a Vale employee, the Managing Director and the Leader (in view of his holding the Corporate Resources portfolio) were advised at the point of application or shortly after if they were unavailable. 

 

Appropriate attendance at strategy meetings to agree how investigating agencies would manage the allegation was determined by the designated safeguarding officer in Social Services, who chaired all strategy meetings under Part IV of the All Wales Child Protection Procedures.  Where allegations involved education staff, the Head or Deputy Head would attend the strategy meeting (unless the allegation related to them), plus the designated safeguarding officer in the Learning and Skills Directorate.

 

Police representatives attend all strategy meetings.  In every case of professional abuse, the meeting always considered whether a criminal investigation was appropriate.  Social Services and the Police would investigate jointly if appropriate. 

 

Outcome review meetings were convened as appropriate to review progress and to manage risk until the matters had been properly concluded.  Minutes were taken of all strategy meetings, and these were securely distributed to attendees for information and retention on their files. 

 

Between 1st April, 2011 and 31st August, 2012, 41 allegations of professional abuse received by Social Services crossed the threshold for a strategy meeting.  38 of these matters had concluded, and 3 were currently ongoing, 2 of which were subject to Police investigation and 1 to investigation by Social Services.  12 of the 41 allegations had related to Vale of Glamorgan Council staff, 6 in Social Services, 5 in Learning and Skills and 1 in Development Services. 

 

Of the 38 concluded matters:

  • 8 of the allegations were retracted
  • 10 were investigated by the Police; 13 were investigated by Social Services
  • 1 was investigated jointly by both agencies.

22 of the 38 allegations involved investigation by the employer, either in addition to Social Services / Police investigation once these processes had been concluded or as agreed by the strategy group where Police or Social Services investigation was not required. 

 

Each allegation that crossed the threshold for a strategy meeting was finalised and the outcomes agreed.  This involved the strategy group reconvening once Police/Social Services investigations had ended to evaluate the information and to determine on the balance of probability whether there was substance to the allegation.  It would also involve deciding if any further action was required and giving advice to the employer where steps to be taken were within their remit. 

 

None of the 38 concluded matters in the reporting period had resulted in individuals being charged with offences.  Where disciplinary processes had been instigated, the relevant employer had taken responsibility for bringing those processes to a conclusion following the Part IV process.  This may involve changes to organisational policies, strengthening safeguarding arrangements and/or additional training of staff.  Where disciplinary processes had resulted in dismissal and required employers to refer individuals to the Independent Safeguarding Authority, the Care Council and/or the Care and Social Services Inspectorate Wales, this had been done. 

 

RECOMMENDED -

 

(1)       T H A T the contents of the report and the work undertaken to ensure best practice in managing allegations of professional abuse be noted.

 

(2)       T H A T the Director of Social Services provide a report every six months about how allegations of professional abuse had been managed by the Council.

 

Reason for recommendations

 

(1&2)  To ensure that the Council has in place effective arrangements for overseeing this key area of work for safeguarding children.

 

 

398     SOCIAL SERVICES REPRESENTATIONS AND COMPLAINTS - ANNUAL REPORT 2011/12 (DSS) -

 

Committee received a report which advised on:

  • The Social Services Representations and Complaints Procedure.
  • Activity, performance and achievements within this important area of work during 2011/12.
  • Improvements planned for 2012/13.

The Annual Social Services Representations and Complaints Annual Report was attached at Appendix 1 to the report.  It covered the period 1st April, 2011 to 31st March, 2012.  As detailed in the report, the Directorate received 144 concerns or complaints in 2011/12.  The breakdown across the service was as shown below:

 

 

Enquiries*

Complaints

Adult Services

19

53

Children and Young People Services

18

43

Business Management and Innovation

1

10

Total

38

106

 

* An enquiry is an issue of concern to the service user, dealt with by the team, without escalation to a complaint.  Only 2 out of the 38 enquires became a Stage 1 complaint.          

 

There was a decrease in the number of enquires recorded from 43 in 2010/11 to 38 in 2011/20.  In the same period, there was an increase in the number of complaints from 68 to 106.  A number of factors appear to have contributed to this increase:

  • More people decided to progress their complaints as registered complaints, rather than agree the matter could be resolved earlier.
  • The increase was attributable in part to service users and their families being made more aware of the Complaints procedure and the continuing improvements being made to the recorded procedure.  There had been more publicity for the Representations and Complaints Procedure on the Vale of Glamorgan Council website, and training to ensure that staff were aware of their responsibilities to comply with it.
  • An increased number of referrals had been received which involved use of formal safeguarding and protection procedures; this work tended to generate more complaints.
  • A campaign against day service re-design generated an identical complaint from a number of service users and carers.

The Social Service Procedure included timescales within which complainants should have received a response to their complaint.  The performance against these timescales had improved year on year, and in 2011/12 achieved 91% compared to 63% in 2010/11 and 26% in 2009/10.

 

Appendix 1 to the report showed that Social Services received a higher number of complaints in 2011/12, but there had been an increase in those resolved at Stage 1.  This had been achieved mainly by the commitment of managers to achieving early resolution and increased monitoring.  It also highlighted the importance of negotiating with the complainant about the resolution they wanted from the process, as outlined in the Complaints Policy and Procedure. 

 

Complaints against staff were the most common, partly because of the sensitive and sometimes contested nature of the work which staff undertook but also because the statutory basis for Social Services was very complex.  A number of complaints arise in circumstances where staff had acted appropriately in delivering the Council's policies and priorities but this may not have been acceptable to families.  The improved performance in achieving early resolution of complaints demonstrated the extent to which good investigations could provide opportunities for reconciling different perceptions. 

 

Where staff had acted inappropriately or without sufficient sensitivity, managers remained committed to taking effective action in response and to insist on the highest standards of practice in all cases, especially in treating people with respect and dignity.

 

Similarly, where the Directorate had not kept its commitments or had failed to meet service standards, the Directorate were quick to apologise and to rectify matters.  In seeking continuous improvement, complaints were used to ascertain the need for reviewing policies and procedures. 

 

Compliments were also regarded as important information that could be used to identify good practice.  The Directorate received 58 compliments during 2011/12 compared to 8 during 2010/11. 

 

During 2012/13, the priorities for developing the complaints and compliments service included:

  • Implementing any changes necessary following Welsh Government consultation on proposals to change the statutory complaints procedure.
  • Ongoing training programme to include complaints awareness session with managers and their teams. 
  • Improving compliance with set timescales for dealing with complaints.
  • Further increasing the numbers of Independent Investigators and Independent Persons on the database.
  • Reviewing the complaint information leaflets for use by adults, children and young people with learning disabilities.
  • Agreeing with the Corporate Complaints Team a process for collating feedback from complaints
  • Further developing the monitoring and evaluation process to improve the ability of the Directorate to learn from complaints and to use the outcomes and recommendations arising from complaints to improve services.

RECOMMENDED -

 

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

 

(2)       T H A T Committee continues to receive an Annual Report in relation to complaints and compliments received by the Social Services Directorate.

 

Reason for recommendations

 

(1&2)  To ensure effective scrutiny of a key function undertaken by Social Services.

 

 

399     COMMISSIONING ADULT SOCIAL CARE SERVICES FROM THE INDEPENDENT SECTOR (DSS) -

 

Committee were updated regarding the commissioning arrangements in place for adult social care services in the Vale of Glamorgan. 

 

On 16th July, 2012, Scrutiny Committee had considered the arrangements that the Directorate had in place to secure services from the Third Sector.  The report before Members outlined the contracting arrangements that currently operated in respect of the independent sector (i.e. organisations which seek to achieve a profit).  It was noted that the Council retained a statutory accountability for the way in which the services were provided.

 

During 2011/12, Social Services spend £18.2m on services that were provided via contractual arrangements with the independent sector.  Of this amount, £10.7m was spent on care home services (which included nursing and residential care) and £7.5m on domiciliary care services (which included home care and day care services).  A list of the relevant organisations was shown at Appendix 1 to the report.

 

In order to provide services on behalf of the Vale of Glamorgan, providers must be on the Social Services Approved Provider List.  This involved:

  • Signing the Heads of Agreement documentation. This is a document that gave a generic service specification which alongside general terms and conditions and in conjunction with an individual care plan for each service user collectively formed the contract.
  • Complete a questionnaire in relation to the services they provide.
  • Provide a breakdown of their costs.
  • Give evidence of Public Liability Insurance to £5m.
  • Give evidence of Employer ‘s Liability Insurance to £10m.
  • Demonstrate that they are registered with the Care and Social Services Inspectorate Wales (CSSIW), where appropriate.
  • Provide references.  If the provider was based in the Vale, two references were required.  If the provider is out of county, the Council required the host authority to confirm that a) the provider was on their list, b) the provider was currently being used and c) they had no concerns including Protection of Vulnerable Adult issues.

Once a provider had been placed on the Approved Provider List, ongoing monitoring took place to ensure that quality standards were maintained.  This included:

  • Ensuring that insurance cover was maintained on an annual basis.
  • Requiring providers to undertake an annual questionnaire in relation to their business.
  • Collating information gathered via complaints, service monitoring reports and POVA (Protection of Vulnerable Adults Arrangements) issues to identify any trends or problematic areas.
  • Undertake spot visits, if required.
  • Undertake arranged visits when time and resources permit.
  • Share and discuss concerns with CSSIW.
  • Scrutinise CSSIW inspection reports and seek satisfactory resolutions to recommendations for immediate action, if required.

CSSIW had a key role in the regulation of services in social care.  Care home and domiciliary care providers must be registered with CSSIW in order to provide services.  This would ensure that they met minimum standards.  As a regulating body, CSSIW undertook inspections of all registered providers, announced and unannounced, and the resulting reports were all made public.  Through the Directorate's monitoring processes, any concerns identified in the CSSIW reports were followed up with the individual providers.

 

There was a sub-group for the Area Adult Protection Committee that brought together individuals from a number of organisations who worked in delivering Protection of Vulnerable Adults arrangements, complaints, advocacy and contracting.  Through this group, information was shared and concerns addressed.  This pioneering approach had proved to be a robust way of monitoring the quality of service provision and ensuring that service users were safeguarded.

 

With regard to domiciliary care services, surveys were undertaken to ensure that staff were appropriately trained.  In addition, service user questionnaires would be used to gather information and feedback about the services provided to vulnerable people in the Vale. 

 

It was essential that staff working with vulnerable people did not pose any form of threat to the service users and that they were suitably qualified to undertake their roles.  All staff within provider organisations were required to have a current Criminal Record Bureau check and this was inspected by CSSIW as part of their monitoring process.  There was a qualification framework in place for social care services which identified the appropriate qualifications for all staff within the service.

 

The Care Council for Wales was making more vigorous the requirements with regard to the registration of individuals.  For a number of years, social workers had to be registered with the Care Council in order to practice.  This was being extended into direct care.  Care home managers must now be registered and domiciliary care managers were the next group to be included in the compulsory registration process.

 

There were two provider forums in the Vale of Glamorgan - one for care homes and one for domiciliary care.  The forums enabled providers for all sectors to share information and consider developments for the service.  This had enabled all providers to share good practice and to keep up to date with the changes in social care, thereby maintaining service quality.

 

Members of the Committee expressed gratitude for the information contained within the report, and questions ensued, including whether the Council conducted annual inspections on the service providers.  The answer to this question was that no, the Council did not conduct investigations but carried out checks to see if the providers were eligible to be included on the Council's list.

 

A Member enquired if there were any providers included on the Council's list who were not CSSIW regulated, where appropriate, and was advised that there were not. 

 

Members were advised that the Council must be vigilant.  The Council could not afford to be complacent. 

 

Following discussions, it was

 

RECOMMENDED -

 

(1)       T H A T the current arrangements for working with the independent sector in providing social care services be noted.

 

(2)       T H A T Cabinet be requested to agree to users of services provided by the Independent Sector be consulted as part of the tendering process, wherever possible.

 

(3)       T H A T Cabinet be requested to agree that the Vale of Glamorgan ensures that all of its Independent Sector suppliers are CSSIW compliant, where appropriate.

 

(4)       T H A T Cabinet be requested to request CSSIW publish a list of their approved Independent Sector providers.

 

(5)       T H A T, when representatives of CSSIW address the Committee at their Annual Meeting, they be asked as to the frequency of their inspections of Independent Sector Care Providers.

 

 

400     UPDATE REPORT ON BRYNEITHIN AND TY DYFAN (DSS) -

 

Ms. M. Farbrace of the 'Save Bryneithin' campaign was in attendance and was permitted to address the meeting. 

 

Ms. Farbrace advised Committee that she was an advocate for Bryneithin and addressed the Committee on a number of issues, including:

  • Regarding the second recommendation as contained within the report before the Committee, this was known in 2008.  Since then, there was still no plan.  People who require resources were not getting them.
  • Bryneithin could be attracting much revenue to the Council.
  • Bryneithin was not being used for respite care.
  • Keeping this provision in-County was essential, but it was acknowledged that some people would have to receive treatment 'out of county' because of a lack of provision within the Vale.
  • Ty Dyfan was not included in the earlier consultation exercise.
  • The respite element of Bryneithin has been removed.
  • Some of Bryneithin has been upgraded.
  • Bryneithin was up and running and should be reconfigured.
  • Why was Ty Dyfan not commissioned as an EMI?
  • Ms. Farbrace was aware that the Vale were looking for a site for a 'Dementia Village', and asked if Bryneithin would be considered.
  • Finally, Ms. Farbrace requested the Committee to reconsider its proposals to close Bryneithin.

Ms. Farbrace was thanked for her address.

 

Committee then received a report which provided an update on Bryneithin and Ty Dyfan which advised that, in May 2008, Cabinet had authorised the Director of Social Services to begin work to develop a strategy which would enable the Council to identify and put in place an appropriate range of accommodation options for older people needing care.  As part of this work, Social Services conducted a review of the three Council-run residential care homes (Bryneithin, Southway and Cartref Porthceri).  In December 2009, Cabinet agreed a plan to close Bryneithin and to transfer residents to other homes as appropriate.  In coming to its decision, Cabinet recognised that officers would need to consider not only the needs of current residents within Bryneithin but also how best to reshape services for older people with mental ill health to meet current and projected demand.  Hence, the plan included a proposal to re-designate Ty Dyfan as an EMI home for people with dementia related illnesses, thereby providing additional specialist beds within the Vale of Glamorgan and places for any residents from Bryneithin who wanted to move there. 

 

Following representations on behalf of the resident's families, the Council accepted that it had previously entered into a contract with the residents to give them a 'home for life' within Bryneithin, provided that the home was able to meet their assessed needs.  Consequently, Bryneithin had remained open, with a reducing number of residents.  The Cabinet decision regarding closure has stood and no new residents had been accepted by the home since that time.  Bryneithin currently provided for one resident. 

 

Following the decision that Bryneithin should remain open for current residents, work was undertaken to mitigate any additional costs falling upon the Council as a result of the non-closure and the impact upon plans for changing the use made at Ty Dyfan.  As part of this plan, the staffing establishment in Bryneithin had been adjusted continually to ensure that staffing levels were appropriate at all times for the reducing number of residents in the home.

 

Ty Dyfan was a 32 bed residential care home and was managed by the Council as part of a bigger contract with Hafod Care.  The contract in relation to Ty Dyfan was agreed in 1991 for a 25 year period, which included the following terms of agreement:

  • The building was leased to Hafod, for which the Council received a payment.  For the duration of the contract, the maintenance of the property was the responsibility of Hafod. 
  • The staff group in the home was employed by the Council, and Hafod made a contribution to the staffing costs but did not meet the full costs.
  • Any placements made by this Council were paid at the agreed contract rate for older people's independence at residential care placements.

In 2009, the contract for the home was re-negotiated as part of the plans to facilitate the closure of Bryneithin, to ensure that adequate alternative provision was available for those residents and to meet increasing needs for specialist 'Elderly Mentally Infirm (EMI)' provision. 

 

Under the terms of the new agreement, the Council agreed:

  • To block book the 32 beds so that only the Council could place individuals in the home.
  • A reduced fee per bed.
  • To pay for the increased staffing required for changing the status of the home.

The revised arrangements with Hafod remained in place.  Most of the residents in Bryneithin did not move to Ty Dyfan.  Partly for this reason, the provision of 20 places in Ty Dyfan had proved sufficient to meet the need.  Another factor had been that, in both of the Council's own residential care homes and in the independent sector, there appeared to have been a shifting balance - away from placements for 'frail elderly' towards 'EMI' provision.

 

However, should there be evidence of further unmet need for EMI residential care home placements, the unoccupied unit at Ty Dyfan could be made available.  This would be dependent upon being able to use staff currently employed elsewhere within Council run homes in order to minimise any additional costs.  Additionally, the Council had approached Cardiff and Vale University Health Board (UHB) with a proposal to develop a 'step up/step down' provision within the unit, avoiding the need for an unplanned hospital admission or supporting a hospital discharge.  There were also discussions with the UHB about whether the home could be used to meet the need for EMI nursing home placements.

 

Senior officers from the Council were pursuing discussions with Hafod Care about the terms of the current contract.  Currently, these discussions were focussed on achieving an equitable share of the costs if Ty Dyfan were to make available an increased number of places.  Negotiations also included the overall contract with Hafod Care and the Council was very concerned to bring these to a conclusion if possible. 

 

In November 2011, Cabinet approved a Commissioning Strategy for Older Peoples Services 2011 - 2018.  This strategy provided considerable detail about the context which the Council needed to consider in making arrangements for providing an appropriate range of care and support services.  It included an analysis of the needs of the community and a strategy for managing increasing demand within an increasingly difficult economic environment.  Production of the strategy was used as an opportunity to further the Council's overall programme for improving and modernising the social care services it provided for older people and their families. 

 

The strategy needed to be informed by new evidence that emerged about needs, costs, preferences of older people and their families etc.  Despite significant rises in the population of very old people, on a national basis the proportion of them who used places in care homes was reducing. 

 

Last year, however, the Vale significantly increased the number of care home placements it made, with the biggest rise in older people's nursing home care and EMI residential care.  The position was shown in Table 1 of the report.

 

Local data on placements made for older people in the Vale indicated that over 80% of required placements were made within county.  As some service users wanted out of county placements in order to live closer to their relatives, this suggested that overall availability of placements was sufficient.  The one area where there was a much lower ratio of in-county placements was EMI nursing.  Through the Wyn Campaign, there were new services being put in place for older people which would have an impact on this position.  This included provision of reablement services and an EMI crisis team. 

 

As part of the Wyn Campaign, a task group was examining how the three organisations could collaboratively plan for and provide effective long term health and social care, including placements in residential care and nursing homes.  Current work included the production of an agreed market position statement and a business case for a joint commissioning unit.  One of the priorities for the group would be to consider the position in respect of EMI nursing placements, especially as this was having an adverse effect on the collective ability to maintain good Delayed Transfer of Care performance. 

 

Following discussions on the contents of the report, it was

 

RECOMMENDED -

 

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

 

(2)       T H A T a further report be brought to Scrutiny Committee once a plan had been developed with partner agencies who are using Ty Dyfan and other facilities to meet the overall need for residential care and nursing home placements for people with dementia related illnesses.

 

(3)       T H A T Cabinet be requested to give consideration to the future use of Bryneithin as a site for social care, subject to ongoing contractual commitments.

 

Reasons for recommendations

 

(1)       To ensure effective scrutiny of key developments in the delivery of these frontline services.

 

(2)       To ensure that effective use is made of the Council's resources.

 

(3)       To give consideration to the future use of Bryneithin.

 

 

401     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 items of business on the grounds that they involve 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.

 

 

402     UPDATE REPORT ON BRYNEITHIN AND TY DYFAN: THE FINANCIAL IMPLICATIONS OF THE CURRENT CONTRACT WITH HAFOD CARE IN RESPECT OF TY DYFAN (DSS) (EXEMPT INFORMATION - PARAGRAPH 14) -

 

Committee received details of the Council's agreement with Hafod Care whereby all the beds at Ty Dyfan were available to the Council under a block booking arrangement.

 

RECOMMENDED - T H A T the details of the block booking arrangement as detailed in the report be noted.

 

Reason for recommendation

 

Having regard to the information included within the report.

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