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SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)

 

Minutes of a meeting held on 15th July, 2013.

 

Present:  Councillor R.L. Traherne (Chairman); Councillors Ms. R. Birch, Ms. K. Edmunds, E. Hacker, Dr. I.J. Johnson, J.W. Thomas and S.T. Wiliam.

 

Also present: Councillor S.C. Egan.

 

 

221     APOLOGIES FOR ABSENCE – 

 

These were received from Councillor Mrs. M.E.J. Birch (Vice-Chairman); Councillors R.J. Bertin and Ms. R.F. Probert.

 

 

222     MINUTES – 

 

RECOMMENDED - T H A T the minutes of the meeting held on 17th June, 2013 be approved as a correct record, subject to the words "a vote was held and was defeated" after the word "EU" as contained in the third paragraph of page 10 of the minutes.

 

 

223     DECLARATIONS OF INTEREST –

 

No declarations were received.

 

 

224     DELIVERY OF CHILDREN’S DISABLED FACILITIES GRANTS (REF) –

 

Scrutiny Committee (Corporate Resources), on 4th June 2013, considered concerns expressed previously regarding the ongoing underperformance in the delivery of disabled facilities grants.  However, Members considered that the report before them did not reflect the minutes of the last meeting or the concerns that had been raised previously. 

 

The Principal Housing and Pollution Officer in referring to the report stated that following the implementation of Wales Audit findings to monitor the stages of DFGs (Disabled facilities Grants) during quarter 3 of 2012/13 it had been noted the time taken for occupational therapy to assess a child for a DFG was increasing significantly in comparison to adults as detailed in the table below.  This table detailed the time taken from first contact with the Council to the DFG team receiving the Occupational Therapist assessment of need across each quarter during 2012/13.

 

 

2012/13

Q1

Q2

Q3

Q4

ALL

85

126

115

115

ADULTS

71

92

89

98

CHILDREN

177

303

256

267

 

Although noting that performance had improved year on year from 2009/10, 2012/13 Members considered that the report did not address suggestions for  radical measures that needed to be put in place in order to reduce the figures further.  The target level for Performance Indicator PSR009A of 510 days was in their view not suitable and that further staffing arrangements should be considered.

 

In response the officer advised that for Children's Services 9 cases were noted at the time the report had been written. These cases had now been allocated and fast-tracked through the DFG system following the decision that all applications for children were to be dealt with as soon as they were received.

 

In explaining certain issues contained within the report the officer also advised that Children's Disabled Facilities Grants were often more complex although the Planning Department did recognise the need for the urgency required in respect of such applications in order to avoid delays. These would be addressed on a case by case basis.

 

Reference was made to the fact that the Public Protection Department was financing an OT to support the OT Team with a closing date for applications for the post due shortly. The officer was hopeful that the appointment could be made within the next couple of months.  An additional OT had also been funded on a temporary basis to address the backlog for adults.  With regard to the PIs Members were made aware that an immediate improvement would not be seen as reports were presented on a quarterly basis and it would take 12 months for the impact to take effect.  Furthermore although the appointment of extra staff would see an improvement in the PI there was currently 260 days already in the system for current cases which the authority could not do much about.

 

With regard to why one vacancy had been subject to a long delay the officer advised that this had been due to the Social Services team being restructured, some maternity issues within the Occupational team and discussions ongoing with the Health Authority for a rotational scheme to be established. In response to a query regarding as to the point at which a DFG process commences, the officer advised that it was when the first contact was made with the local authority and the client was waiting for an assessment.

 

Some Members, in referring to the vacancy factor, were aware that a number of reasons would contribute to delays but were still of the view that radical measures needed to be considered to address the backlog. Members also felt that other local authorities seemed to be responding more favourably to such applications and suggested that collaborative working may be a way forward.  All agreed that the filling of vacancies should be seen as a priority.

 

Following suggestions that contracts and frameworks could be streamlined the officer advised that she was currently looking into these aspects but that there were obstacles such as VAT, ownership of the grant and implications on the Council's RSG and capital funding settlement from Welsh Government. 

 

Having considered the report and the concerns raised above Members also agreed that a further report to identify all the issues and delays should be presented to the Committee, following which Scrutiny Committee (Corporate Resources) had

 

Recommended -

 

(1)       That Cabinet be advised of the concerns of the Committee in that the report had not addressed the concerns raised at the last meeting on 23rd April 2013, in particular the concerns regarding the waiting list and the urgent need for more innovative solutions to the problems to bring down the number of days via a step change reduction in the number of days.

 

(2)       That a further report be presented to the Scrutiny Committee on the issues referred to above, the delays involved and the stages of the processes in the delivery of Disabled Facilities Grants for children and adults.

 

(3)       That the report be noted and referred to Cabinet for consideration.

 

(4)       That the report and the minutes of the meeting be referred to the Scrutiny Committees (Housing and Public Protection and Social Care and Health) for information and to advise of the concerns that had been raised.

 

The Chairman advised the Committee that Scrutiny Committee (Housing and Public Protection) had considered the above reference which had been noted by the Committee. 

 

With the permission of the Committee, Councillor S.C. Egan, Cabinet Member for Adult Services, advised that Cabinet had considered that afternoon a report which advised of changes that had been made in the processing of Disabled Facilities Grants to improve the delivery time.  It also outlined further changes planned for 2013/14. 

 

Cabinet had

 

Resolved –

 

(1)       That the Disabled Facilities Grants Delivery Improvements Action Plan be agreed.

 

(2)       That a copy of the Disabled Facilities Grants Delivery Improvements Report be submitted to the Scrutiny Committees (Corporate Resources), (Social Care and Health) and (Housing and Public Protection) for information purposes. 

 

(3)       That a detailed report on Disabled Facilities Grants be brought to Cabinet on a quarterly basis.

 

(4)       That staff be thanked for all their hard work on the Disabled Facilities Grants Delivery Improvements.

 

Committee’s attention was drawn to the table in the second paragraph of the reference which indicated the time taken from first contact with the Council to the Disabled Facility Grants team receiving the Occupational Therapist’s assessment of needs. 

 

Members observed that the time taken seemed excessive and they were advised:

 

-         all of the services worked to a budget

-         this service had experienced staffing problems

-         the time taken would fall in the future

-         at first contact, it was often the case that clients did not always know what their requirements might be.  This required the assessment of an Occupational Therapist.

-         the children’s element of Disabled Facilities Grants had lagged when compared to adults as it was often the case that children’s needs were more complex.

 

A Member observed that it was worth noting that the time taken to deal with these applications had reduced.  The complexity of the assessments also needed to be borne in mind. 

 

RECOMMENDED –

 

(1)       T H A T the recommendations of Scrutiny Committee (Corporate Resources) held on 4th June 2013 be noted.

 

(2)       T H A T the reference from Cabinet of 15th July 2013 be awaited.

 

Reasons for recommendations

 

(1)       Having regard to the decision of the Scrutiny Committee.

 

(2)       Having regard to the decision of Cabinet.

 

 

225     SITE INSPECTION (MD) –

 

RECOMMENDED – T H A T the attendance of the following Members at the site indicated below on 27th June 2013 be noted:

 

Apologies for absence were received from Councillors R.J. Bertin, Ms. K. Edmunds, E. Hacker and S.T. Wiliam. 

 

Former Bryneithin Residential Home, St. Andrews Road, St. Andrews Major, Dinas Powys

Councillor R.L. Traherne (Chairman); Councillors C.P. Franks, Mrs. V.M. Hartrey, K. Hatton, Dr. I.J. Johnson and J.W. Thomas.

 

 

Reason for recommendation

 

To note the attendance at the site inspection.

 

 

226     END OF YEAR PERFORMANCE 2012/13 AND PERFORMANCE INDICATORS 2013/14 (MD) –

 

Committee were:

 

-         presented with end of year performance and action monitoring reports for the year ended 2012/13

-         notified of the changes to performance indicators and performance reporting arrangements for 2013/14.

 

Service plans for 2013/14 had been revised and were now designed to focus on the achievement of objectives within each Directorate in order to contribute towards outcomes for members of the public.

 

A review of performance indicators had taken place to ensure that the Council collects indicators which effectively monitored service plan objectives and outcomes.

 

Committee received the action monitoring and performance reports monitored by the Committee by service area. 

 

An additional document was listed for each service which listed all the performance indicators proposed for collection as part of 2013/14 service plan monitoring.  All measures had been renamed for ease of reference in relation to the new service plans.  Newly proposed performance indicators were also shown. 

 

In the process of reviewing performance indicators for 2013/14, it had been noted that the corporate indicators collected within all service areas were cross cutting and did not directly contribute to any one objective within service plans.  It was therefore proposed that sickness (long term, short term and overall), leavers and PDR figures for all service areas be reported to Corporate Resources Scrutiny Committee in one report on a quarterly basis from 2013/14 onwards. 

 

Having considered the report, it was

 

RECOMMENDED –

 

(1)       T H A T the performance and action monitoring reports for end of year 2012/13 be noted.

 

(2)       T H A T the changes to the performance indicators and reporting arrangements for 2013/14 be agreed.

 

Reason for recommendations

 

(1)       To ensure that the Council is effectively monitoring and improving its performance in line with the requirements to secure continuous improvement and comparison, outlined in the Local Government (Wales) Measure 2009.

 

(2)       To ensure that arrangements for the collecting and reporting of performance information reflects Scrutiny Committee priorities and is in keeping with the new service planning and reporting arrangements.

 

 

227     SCRUTINY DECISION TRACKING OF RECOMMENDATIONS (DR) –

 

Members were advised of progress in relation to recommendations made by the Scrutiny Committee for:

 

·         Financial Year 2012 – 13

·         1st Quarter April to June 2013.

 

Following discussions on the content of the report, it was

 

RECOMMENDED – T H A T the following recommendations be deemed completed and deleted from the decision tracking:

 

16 July 2012

Min. No. 142 - Social Services Budget Programme (DSS) – Recommended

(3)   That a detailed business case for specific projects contained within the Programme Plan be prepared.

 

 

Cabinet, on 30th July 2012, recommended that a detailed Business Case for specific projects contained within the Programme Plan be prepared and submitted to the relevant Scrutiny Committee and Cabinet as soon as practicable.  (Min. No. C1790 refers).

Completed

Min. No. 143 - Setting a Standard Contracting Rate for Places in Independent Residential Care Homes for Older People in 2012/2013 (DSS) – Recommended

(2)   That Cabinet be recommended to agree the final fee by September 2012.

 

 

 

 

 

Committee resolved that his matter be deleted from decision tracking.

Completed

03 September 2012

Min. No. 261 - Telecare Services (DSS) – Recommended

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

 

 

Committee resolved that this matter be deleted from decision tracking.

Completed

14 January 2013

Min. No. 725 - Guidance and Priorities for the Adaptation of Homes of People with Impairments (DDS) – Recommended

(4)That Scrutiny Committee (Social Care and Health) be advised of any changes to the document as the result of recommendation (3) above.

[(3)   That the Director of Development Services, in conjunction with the Cabinet Members Housing, Building Maintenance and Community Safety, Children’s and Adult Services be given delegated authority to review and make changes to the Guidance and Priorities for the Adaptation of Homes of People with Impairments document, as appropriate.]

 

 

 

Committee resolved that this matter be deleted from decision tracking.

Completed

Min. No. 726 - Revenue and Capital Monitoring for the Period 1st April 2012 to 30th November 2012 and Update on the Social Services Budget Programme (DSS) – Recommended

(4)   That Committee be advised periodically of the outcome of the Revocation of Care Orders as referred to in Reference C8 of Appendix 4 to the report.

 

 

 

 

 

Reported to Scrutiny Committee (Social Care and Health) on 20th May, 2013

Completed

11 March 2013

Min. No. 966 - The Council's In-House Fostering Service (DSS) – Recommended

(3)   That the Committee’s appreciation of the work being undertaken by the foster carers, and their value to the Authority, be conveyed to all foster carers in the form of a letter signed by the Chairman of the Committee.

 

 

Committee resolved that this matter be deleted from decision tracking.

Completed

15 April 2013

Min. No. 1049 - The Future of Bryneithin Care Home Site (Request for Consideration) –

Min. No. 1049a - The Closure of Bryneithin Residential Care Home (REF) –  Recommended

(2)   That Cabinet be requested to give consideration to the future use of Bryneithin as a site for social care.

 

(3)   That a progress report be brought before each future meeting of the Scrutiny Committee (Social Care and Health), to include the issue of the security of the site.

 

 

 

 

 

 

(2)   Cabinet, on 8th May 2013, noted the contents of the report (Min. No. C1317 refers).

Completed

(3)   Added to work programme schedule.

Completed

Min. No. 1050 - Standard Rate for Contracting Places in the Independent Sector (Request for Consideration) – Recommended that the Committee receive regular updates on this matter in the future.

 

 

 

Added to work programme schedule.

Completed

Min. No. 1052 - The Vale of Glamorgan Health, Social Care and Wellbeing Partnership (DSS) – Recommended

(2)   That Committee continues to receive reports every six months on the work of the Health, Social Care and Wellbeing Partnership.

 

 

 

Added to work programme schedule.

Completed

20 May 2013

Min. No. 27 - Task and Finish Activities for 2013/14 (HDS) – Recommended

(3)   That the review to be submitted for consideration on behalf of the Scrutiny Committee (Social Care and Health) be as follows:

·        How do we ensure the future delivery of the care of older people within Social Services.

 

 

Referred to Scrutiny Committee Chairmen and Vice-Chairmen Group meeting of 25 June 2013.

Completed

Min. No. 28 - Update on the Social Services Budget Programme (DSS) – Recommended

(2)   That the changes to the Social Services Budget Plan for 2013/14 to 2016/17 as outlined above be endorsed and referred to Cabinet for approval.

 

 

 

Cabinet, on 17 June 2013, approved the changes as outlined in the report (Min. No. C1357 refers).

Completed

Min. No. 29 - Update Report: Managing Allegations of Professional Abuse – Compliance with Part IV of the All Wales Child Protection Procedures (DSS) – Recommended

(2)   That the Director of Social Services provide a report on a six monthly basis about how allegations of professional abuse have been managed by the Council. 

(3)   That the report be presented to Cabinet for information.

 

 

 

 

 

(2)   Added to work programme schedule.

Completed

 

 

(3)   Cabinet, on 17 June 2013, noted the report and resolved that the six monthly report in recommendation (2) be presented to Cabinet and that the six monthly reports prepared for CMT also be reported to Cabinet (Min. No. C1358 refers).

Completed

17 June 2013

Min. No. 83 - Social Services Change Plan 2011-2014: Progress Report (DSS) – Recommended

(3)   That the progress report be referred to Cabinet with a recommendation that:

(i)     changes to the Plan be endorsed;

(ii)   remaining actions in the Plan be transferred to the Directorate’s Service Plan, as agreed by Scrutiny Committee on 11th March and by Cabinet on 8th April 2013.

 

 

 

 

Referred to Cabinet meeting on 15th July 2013.

Completed

Min. No. 84 - Revenue and Capital Monitoring for the Period 1st April 2013 to 30th April 2013 (DSS) – Recommended

(2)   That the progress made on the Social Services Budget Programme be noted and referred to Cabinet for information.

 

 

 

Referred to Cabinet meeting on 15th July 2013.

Completed

Min. No. 85 - Update on the Development of Families First Services (DSS) – Recommended

(3)   That annual updates on progress with the Families First Service be provided to Committee annually.

(4)   That Committee receive a further report outlining case studies and their outcomes.

(5)   That the Members of the Committee be informed of how the grant money is allocated within the Families First Service and also informed about the referral criteria for the Families First Service by e-mail.

 

 

 

(3)   Added to work programme schedule.

Completed

 

(4)   Added to work programme schedule.

Completed

 

(5)   E-mail sent to all Members on 18th and 24th June 2013.

Completed

Min. No 86 - South Wales Programme Consultation – Recommended that the individual Councillors’ responses to the consultation be taken into account when drafting the Council’s response to the consultation.

 

Cabinet, on 15th July, 2013 will consider comments.

Completed

Min. No. 89 - Bryneithin Update – Recommended

(2)   That all Members of the Committee be invited to attend a site visit at the former Bryneithin Residential Care Home site in order that they might view the ground conditions.

 

 

Site visit held on 27th June 2013.

Completed

 

Reason for recommendation

 

Actions have been completed.

 

 

228     REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL 2013 TO 31ST MAY 2013 (DSS) –

 

Committee received a report which:

 

-         brought to the attention of Committee the position in respect of revenue and capital expenditure for the period 1st April 2013 to 31st May 2013 regarding those revenue and capital budgets which formed this Committee’s remit

-         updated Committee on the progress made in delivering the Social Services Budget Programme.

 

The current forecast was for a balanced budget.  In addition to increased demand for services, there was pressure on the Directorate to achieve its savings targets for 2013/14 onwards. 

 

Children and Young People’s Services – the major ongoing issue concerning this service was the continued pressure to manage the Children’s Placements budget.  Whilst the number of Looked After Children had been decreasing, the children had increasingly complex needs and this could result in high cost placements being required. 

 

Cabinet, on 17th June 2013, had approved the proposal to set up a jointly funded budget for Residential Placements for Looked After Children.  The costs incurred were currently funded by Education and Social Services, with contributions from Cardiff and Vale University Health Board where Continuing Health Care was required.  The process for determining the allocation of costs to each funder could be difficult and time consuming, so it was felt that a joint budget would be a more efficient and effective means of financial management.  The budget for 2013/14 had been set at £3,150,000 with a £2,830,000 (90%) contribution from Social Services and a £320,000 contribution from Education (10%).  The joint budget would be held by Social Services and therefore a virement of £320,000 from Education to Social Services had been actioned.  This was shown in Appendix 1 to the report.  University Health Board contributions, via Continuing Health Care arrangements, would continue unchanged.  There would be great pressure on this budget as the year progressed but the current projected year end position for the joint budget was a break even position.

 

Adult Service – the major issue concerning this service was the continuing pressure on Community Care Packages, which was an extremely volatile budget.  At present, the projected year end position was an overspend of £995,000 which included the savings target for the year of £685,000.  Work was ongoing to ensure that the savings were implemented and the shortfall addressed.  There was a projected increase in income received under the Deferred Payment Scheme which could partially offset this position.  It was considered that the eventual year end position would be a balanced budget.

 

Appendix 2 to the report detailed financial progress on the Capital Programme as at 31st May 2013.

 

With regard to the Social Services Budget Programme Update, the Directorate was currently required to find savings totalling £6,000,000 by the end of 2016/17.  Savings totalling £6,189,000 had currently been identified.  The surplus would be used to mitigate any additional savings to be found in future years.

 

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. 

 

In response to a question regarding Project Reference A3 as contained in Appendix 4 to the report, Committee were advised that there was an increasing number of people suffering from frailty and / or dementia.

 

In referring to Project Reference A6 as detailed in Appendix 4, entitled "Residential Services", Committee were advised that a report would be presented to Cabinet in September. 

 

In referring to Appendix 1 to the report, the Chairman expressed the view that expenditure on Community Care Packages should be identified separately, to be listed under the heading "Adult Services".

 

RECOMMENDED –

 

(1)       T H A T the position with regard to the 2013/14 Revenue and Capital Monitoring be noted.

 

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

 

(3)       T H A T future reports of this nature include information, as a separate line, on expenditure on Community Care Packages in view of the cost pressures in this area.

 

Reasons for recommendations

 

(1)       That Members are aware of the position with regard to the 2013/14 revenue and capital monitoring relevant to the Scrutiny Committee.

 

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

 

(3)       To identify expenditure on Community Care Packages.

 

 

229     CLOSURE OF ACCOUNTS 2012/13 (DSS) –

 

Committee were informed of the provisional financial position of the Social Services Directorate for the 2012/13 financial year.

 

Set out below is a table comparing the amended estimates and the actual expenditure for the Directorate:

 

Service

Amended Revenue Estimate

Total Provisional Actual

Variance Favourable  () Adverse

 

       £’000

          £’000

             £’000

Social Services

 

 

 

Children and Young People

14,092

14,316

(224)

Adult Services

33,914

33,679

235

Business Management and Innovation

293

293

0

YOS

671

655

16

 

 

 

 

Total

48,970

48,943

27

 

 

The main reasons for the variances were as set out below:

 

The budget for all service areas showed a year end underspend of £27,000.  This was after a transfer to provisions of £775,000 and a reduced use of the Social Services Fund of £1,000,000.  As part of the Social Services Budget Programme, £2,544,000 of the Social Services Fund had been approved for use in 2012/13 but only £1,544,000 was required.  The underspend was partly as a result of the actual savings identified for the year being £403,000 in excess of the planned savings required, as set through the Social Services Budget Programme.  In addition, £83,000 was included in the budget for a central energy recharge which was not required in the year.

 

Children and Young People’s Services – Net Adverse Variance of £224,000.  This underspend had occurred as a result of a transfer to provision of £523,000  to fund future high cost residential placements.  There had also been a reduction in the use of approved funding from the Social Services Fund of £116,000.  There had been areas of pressure on this budget which resulted in overspends.  These were the Children’s Placement budget which overspent by £152,000 due to a number of high cost placements and the Fifteen Plus budget overspent by £143,000 due to accommodation costs for homeless young people.  There had been underspends on staffing and transport costs of £67,000, the legal budget underspent by £139,000, £68,000 additional income was received, and other supplies and services underspent by £166,000.  There were further underspends as a result of the underspend within the Business Management and Innovation Division resulting in a reduced internal recharge to Children’s Services of £109,000 and the savings achieved ahead of those required of £161,000. 

 

Adult Services – Net Favourable Variance £235,000.  This underspend followed a transfer to provision of £252,000 which was made to fund potential future increases in Care Home fees in excess of inflation provided in the budget.  There had also been a reduction in the use of approved funding from the Social Services Fund of £884,000.  There was an underspend of £406,000 on Community Care Packages, with an over recovery of £256,000 from income received under the Deferred Payment Scheme.  There had been underspends on staffing costs of £198,000, partly made due to the 1% pay award included in the budget which did not materialise, £71,000 for transport and £33,000 on other supplies and services. There were further underspends as a result of the underspend within the Business Management and Innovation Division resulting in a reduced internal recharge to Adult Services of £165,000 and the savings achieved ahead of those required of £242,000.

 

Business Management and Innovation – Net Variance Nil.  The majority of this budget was recharged to Children’s and Adult Services and was, therefore, showing a breakeven position at year end.  The position before recharges to services was an underspend of £274,000.  This was made up of an underspend of £125,000 on staffing, mainly due to staff vacancies being held under the Protection and Policy heading pending a review of service provision, £20,000 on transport, £46,000 from grant and other income and £83,000 from the central energy recharge which was not required in the year. 

 

Youth Offending Service – Net favourable variance of £16,000.  This consisted of an underspend of central energy recharges £4,000, an underspend within staffing costs due to staff vacancies / maternity leave / limited additional hours £78,000, an overspend within general running costs and premises £15,000 which included one-off contributions towards software upgrades and an overspend within premises due to additional premises expenditure in order to complete building improvements of £51,000. 

 

The overall capital outturn for the Directorate was an underspend of £39,000.  Details of individual schemes was provided in Appendix 2 to the report.  The Day Care Reconfiguration and Gardenhurst scheme underspent by £37,000.  Structural issues were identified at the property which meant intrusive property condition surveys were needed to be undertaken.  This caused delays in the progress of the scheme and it had been requested that £12,000 be slipped into the 2013/14 year so that an in depth building survey could be completed before continuing with renovation works.

 

In noting that the legal budget had underspent by £139,000, a Member enquired as to the size of the budget and was advised that the budget was of the region of £200-300,000.  The reason for the underspend was that a particularly large Counsel’s fee had been expected during the year as a "one-off". 

 

RECOMMENDED –

 

(1)       T H A T the slippage request be noted, it being further noted that the request had been approved by the Managing Director exercising Emergency Powers.

 

(2)       T H A T the remainder of the report and the financial measures taken and proposed be noted.

 

Reasons for recommendations

 

(1)       To note the amendments to the 2013/14 Capital Programme due to slippage from 2012/13.

 

(2)       To note the remainder of the report and the financial measures taken and proposed.

 

 

230     VALE OF GLAMORGAN COUNCIL FOSTERING SERVICE (DSS) –

 

Committee received a report which:

 

-         provided an overview of the Care and Social Services Inspectorate Wales (CSSIW) Annual Inspection 2012/13 and the Review of Quality of Care Report for 2012/13

-         updated Committee on the implementation of the Foster Carer Recruitment Strategy 2013/14.

 

Under the provisions of the Care Standards Act 2000 and associated Regulations, CSSIW undertakes an annual inspection of Local Authorities which provide a Fostering Service.  The inspection for the Vale of Glamorgan took place during February and March, and a copy of the Inspection Report was attached at Appendix 1 to the report. 

 

Under Regulation 42, there was a requirement to complete an annual Review of the Quality of Care provided by the Fostering Service.  A copy of the report was attached at Appendix 2 to the report.

 

The Children and Young People Services Commissioning Strategy 2013-18 identified the need to increase the cohort of in-house foster carers who were able to provide a range of placements.  A Foster Carer Recruitment Strategy was endorsed by this Committee in March 2013. 

 

CSSIW Annual Inspection of the Fostering Service

 

The Inspectors concluded that the Fostering Service:

 

·         was effectively managed

·         was child centred

·         had good systems for consultation

·         provided good support and guidance to foster carers

·         had good systems to inform placement making and matching.

 

A number of improvements made since the 2012 Inspection were also validated.  These included better communication between Children’s Services Teams, improved staff motivation, management practice and systems (for placement making and matching and for monitoring and evaluating the effectiveness of the service).

 

The Inspectors identified only one area for improvement i.e. to further develop systems to undertake the degree to which placements meet the needs of children in accordance with their care plans and foster placement agreements.  It was proposed that this would be addressed by using the statutory Looked After Children review process to improvement outcome-focused care planning and to support Independent Reviewing Officers in challenging appropriately the content of care plans.

 

Review of the Quality of Care 2012/13

 

During 2012/13, considerable progress had been made in the Council’s foster carer recruitment processes.  New systems for managing and responding to initial enquiries had been implemented, including using the Council’s experienced foster carers to undertaken some initial visits, usually within 7-10 days of the initial enquiry.

 

The number of "choosing to foster" training courses had been doubled and the Fostering Service collaborated with other local authorities to improve access to available training, ensuring that prospective applicants could do so within six weeks. 

 

In response to a low conversion rate of initial enquires in previous years, the Fostering Service had created a monitoring system that tracked prospective applicants’ journeys through the recruitment process. 

 

During 2012/13 there had been a 16% decline in the number of enquiries made to the Fostering Service compared to the previous year.  The new Recruitment Strategy was being implemented, and this year would see an increase in marketing and recruitment activity in an attempt to address the decline.

 

Despite receiving fewer applications to foster during 2012/13, the Fostering Service had made significant improvements in assessment and approval activity this year.  Consequently, the overall number of new carers approved this year more than doubled, from 7 in 2011/12 to 15 in 2012/13.  Within this overall figure, the number of mainstream carers approved had seen an even greater increase from 2 to 8.

 

In respect of mainstream (i.e. non-kinship) foster carers, during 2011/12 the Fostering Service approved 2 foster carers from 68 enquiries, which equated to a conversion rate of 3%.  This year, the approval of 8 mainstream foster carers from 57 enquiries demonstrated an increase in conversion rate to 14%, which was in line with the national average. 

 

There had been a decrease in the number of de-registrations and resignations in 2012/13 (18) compared to 2011/12 (26).  There were 11 de-registrations of kinship carers, 7 of which were as a result of the carers obtaining a Special Guardianship Order for the young people placed.  This reduced the number of Looked After Children last year by 12.  The other 4 kinship de-registrations occurred because the placement was no longer required.  There were 7 de-registrations / resignations of mainstream foster carers during 2012/13, 3 were due to the retirement of the foster carers, 3 resigned following an investigation of a complaint or allegation, and 1 because their circumstances had changes and they no longer wanted to foster.

 

The population of Looked After Children had decreased from 219 as at 30th March 2012 to 184 as at 29th March 2013.  During 2011/12, there were 124 children placed with mainstream and kinship foster carers and currently there were 102.

 

Although there had been a very small overall increase in the number of mainstream foster carers this year, the overall number of placements offered had decreased from 128 places in 2011/12 to 114 places in 2012/13.  This was due in part to the fact that newly approved foster carers were initially only approved for one placement until they gained experience whilst those carers who had resigned were able to offer up to thee placements.  In addition, the approval status of some foster carers had decreased following their annual review.  However, there had been a reduction in the number of vacant placements, which had reduced from 26 to 12, demonstrating more efficient use of the Council’s resources. 

 

There had also been a significant reduction ion the number of children placed with Independent Fostering Agencies (IFAs), from 41 during 2011/12 to 30 during 2012/13.  In part, this reduction was accounted for by young people who had moved to specialist residential care.  Importantly, there had not been a rise in the number of IFA placements, despite the reduction in the number of in-house placements available. 

 

The Fostering Service had delivered a 10% increase in the number of foster carer reviews conducted.  At 31st March 2013, 94% of foster carers had up to date Annual Reviews / Approvals, compared to 84% in 2011/12 and 52% in 2010/11.  Completion of Annual Reviews within timescales remained a priority for the team.

 

Foster Carer Recruitment Strategy 2013/14

 

The Foster Carer Recruitment Strategy had been reported to this Committee in March 2013.  It established that a key priority for the Division was to recruit additional in-house carers in order to reduce reliance on those procured through IFAs and to reduce the costs associated with providing services to Looked After Children.

 

The Fostering Service was now implementing the Recruitment Strategy and a Recruitment Officer had been appointed through secondment of an experienced social worker from the Placements and Permanency Team.

 

Beginning with Foster Carer Fortnight in May 2013, increased advertising activity had been launched.  Unfortunately, this had not produced as yet the anticipated increase in expressions of interest in fostering.  Analysis of activity and impact would inform how the Fostering Service and Corporate Communications should implement the future rolling programme of campaign activity.

 

Members enquired as to the activities of the Council in recruiting Foster Carers outside of the Foster Carer Fortnight, and were advised that the Council had a recruitment strategy which focussed specifically on wider-scale advertising, recruitment and assessment opportunities. 

 

Members expressed the view that the Committee should receive a further report giving an update on the effectiveness of the Council’s recruitment policy and that the report should be presented in six months time.

 

RECOMMENDED –

 

(1)       T H A T the positive findings of the CSSIW Annual Inspection be noted.

 

(2)       T H A T the content of the Quality of Care report be noted.

 

(3)       T H A T the implementation of the Foster Carer Recruitment Strategy be supported.

 

(4)       T H A T Committee receive a further report in January 2014 on the Foster Carer Recruitment Strategy in view of the importance of this issue and the difficulties to date in increasing the number of expressions of interest in fostering.

 

Reason for recommendations

 

(1-4)    To assure Scrutiny Committee that the Council’s statutory functions in relation to providing a Regulated Fostering Service were fully met in accordance with legislation and guidance and to provide an update on progress with implementing the Foster Carer Recruitment Strategy.

 

 

231     COMMUNITY MENTAL HEALTH TEAM FOR OLDER PEOPLE (CMHTOP) (DSS) –

 

Committee were informed of the work of the Integrated Community mental Health Team and were provided with an update following a site visit by the Care and Social Services Inspectorate Wales (CSSIW).

 

The CMHTOP was an integrated team comprising staff from the Vale of Glamorgan Council and the Cardiff and Vale University Health Board (UHB).  The team provided care, treatment and support for individuals experiencing severe and / or enduring mental disorders where the level of need, risk and complexity required the provision of specialist care.  The inclusion criteria were:

 

·         adults of any age presenting with systems of a progressive dementia and who were at significant risk due to their behaviour or complex management needs

·         adults who had developed a serious mental illness or disorder for the first time in later life, usually aged 65 or over

·         identified carers of people in either of the other two categories.

 

The CMHTOP were visited by CSSIW in February 2013.  The purpose of the visit was to:

 

·         gain a clearer understanding of what the service offered and its objectives (including governance and accountability)

·         evaluate the outcomes the service produced for service users, their families and carers

·         hear from third sector organisations contributing to the service

·         understand how far integration between social service and health improves the outcomes and supports the Vale of Glamorgan Council to meet its statutory obligations.

 

The themes explored were:

 

·         getting help – including access and eligibility

·         the services provided

·         the effect on people’s lives

·         delivering social services

·         shaping service

·         leadership.

 

The feedback from the site visit was very positive.  A copy of the report was attached at Appendix 1 to the report. 

 

(i)       The service users and carers interviewed by CSSIW Inspectors praised the commitment, level of knowledge and skills shown by workers. 

(ii)      It was acknowledged that the Vale of Glamorgan Council commissioned a range of good quality services for older people who experience a mental illness, their families and carers.

(iii)     The presence of a detailed, progressive Action Plan was noted and Inspectors considered this to be an appropriate response to the report provided previously, the Delivery and Support Unit and NLIAH in November 2012.  Progress in introducing effective referral processes, combined with management and monitoring progress, had contributed to a significant reduction in the waiting times.

 

CSSIW acknowledged the level of purposeful integration between Health and Social Care at many levels of the organisation.  Reintroducing regular meetings with partners had helped to ensure a consistent approach and joint ownership of issues.  These meetings had been extended to include Cardiff Council, to strive for consistency across the UHB area.

 

CSSIW identified some factors which continued to have an impact on performance.  IT system were complex and used in silos between organisations, not supporting integration as much as the team would like.  The different boundaries for social care and health caused continuous challenges on both a practical working level and in providing strategic direction.  CSSIW identified as priorities for improvement:

 

·         improving equity of access to services across the Council area (i.e. Central / Eastern and Western Vale)

·         ensuring regular oversight of the contents and quality of Care and Treatment Plans and other supporting documents

·         developing further partnership working in the Western Vale.

 

These areas were now included in the Action Plan, which was monitored bi-monthly by the joint partnership meeting with Health and Social Care.

 

The Vale of Glamorgan’s Commissioning Strategy for Older People provided strategic direction for older people’s services including those relating to dementia care.  There was no distinct Vale of Glamorgan dementia strategy, as the services were addressed through other strategies and plans. In addition, there were several strategies developed by the Council’s Health partners, in particular "Together for Mental Health".  Having a specific strategy for dementia for the Vale of Glamorgan was unnecessary at this stage.

 

Members noted the comments of CSSIW that the different geographical boundaries caused continuous challenges and enquired what was being done to mitigate this problem.

 

Committee were advised that the Council had instigated a piece of work in this area to promote awareness of CMHTOP.  The intention was to produce an "easy" guide, but this was a complex area and a challenging piece of work.

 

Members suggested that Committee receive a report in six months time to update the Members on this issue.

 

A Member raised the findings of CSSIW that the IT systems were complex and did not support integration as much as the team would like and asked for the views of the Director on this. 

 

Committee were advised that the Council was doing much work in this area but issues such as different electronic case management systems in use across organisations, Data Protection and Data Sharing requirements had resulted in differing amounts of progress in different areas.

 

RECOMMENDED –

 

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

 

(2)       T H A T the progress made by the team over the past 12 months be noted.

 

(3)       T H A T a report be brought before Committee in six months time outlining progress on the promotion of public awareness of CMHTOP care.

 

Reasons for recommendations

 

(1)       To ensure that Scrutiny Committee is aware of the role and function of the Integrated Community Mental Health Team, the recent evaluation of service performance and the impact of introducing the Mental Health (Wales) Measure 2010.

 

(2)       To note the progress that had been made within the team over the past 12 months to improve access to services by older people with mental health issues.

 

(3)       To advise Committee.

 

 

232     MATTER WHICH THE CHAIRMAN HAD DECIDED WAS URGENT –

 

RECOMMENDED – T H A T the following matter which the Chairman had decided was urgent for the reason given beneath the minute heading be considered.

 

 

233a   BRYNEITHIN UPDATE –

(Urgent by reason of the need to ensure timely information is provided regarding the development of the Bryneithin site)

 

It was reported that

 

-         As reported to the Cabinet meeting of 8th April and in accordance with Cabinet Minute C1293 (5) authority was granted for the Director of Social Services to make arrangements for securing the Bryneithin site, including the demolition of the buildings if necessary, in consultation with the Leader, the Cabinet Member for Adult Services and the Managing Director.  As reported previously to Cabinet extensive security arrangements were in place but these were expensive and a drain on the Council's limited resources. The decision had subsequently been taken to proceed with demolition.

-         The target date for awarding the demolition contract was 19th July 2013 assuming the tender process went to plan.  It was intended to hand over the security arrangements to the contractor as part of the demolition process from this date also.  Asbestos and environmental surveys would have to be undertaken and the results of the surveys addressed prior to authorising the demolition stage.  Demolition would begin towards the end of October although this may be subject to change should any problems arise with the previous stages.

-         The Cabinet Working group was launching a consultation phase with key stakeholders and the local community on the initial options. It would also, as part of this consultation, invite any other ideas for development options for the site that would assist in meeting older people's need for care and support.  This consultation period would be launched imminently and last until 14th September. The initial options were:

          ·         Private Residential Development for Older People;

          ·         Registered Social Landlord Residential Development for Older People;

          ·         Private Extra Care Facility;

          ·         Registered Social Landlord Extra Care Facility.

-         Following this exercise and along with other due diligence by the Cabinet Working Group a final list of options would be reported for consideration by Cabinet on 23rd September. 

-         It was intended that future marketing of the site would then commence following the consideration by Cabinet in September.

 

Members of Scrutiny Committee had been invited to view the site and the site visit took place on 27th June, 2013.

 

RECOMMENDED – T H A T the contents of the report be noted.

 

Reason for recommendation

 

Having regard to the contents of the report.

 

 

233b   HEAD OF CHILDREN AND YOUNG PEOPLE SERVICE –

 

Committee Members took the opportunity to thank Gareth Jenkins, Head of Children and Young People Services, for his outstanding work on behalf of the Council prior to his departure to Caerphilly Council.

 

 

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