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SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)

 

Minutes of a meeting held on 1st September, 2014

 

Present: Councillor R.L. Traherne (Chairman); Councillor Mrs. M.E.J. Birch (Vice-Chairman); Councillors R.J. Bertin, Ms. R. Birch, K.J. Geary, Dr. I.J. Johnson, Ms. R.F. Probert and J.W. Thomas.

 

Also present: Councillor S.C. Egan.

 

 

312     APOLOGIES FOR ABSENCE –

 

These were received from Councillor Ms. K. Edmunds.

 

 

313     MINUTES –

 

RECOMMENDED – T H A T the minutes of the meeting held on 14th July, 2014 be approved as a correct record.

 

 

314     DECLARATIONS OF INTEREST –

 

No declarations were received.

 

 

315     CHAIRMAN’S ANNOUNCEMENT –

 

The Chairman began the meeting by informing Members that the first session of the Assistive Technology Task and Finish Group would take place on Tuesday, 2nd September at 9.00 a.m. in Committee Room 3.  Also, on 6th October 2014 at 4.45 p.m. and prior to the next Scrutiny Committee, a workshop had been arranged with the Operational Manager – Accountancy in order to provide Members with an overview of the make-up and structure of the Directorates Budget and a better understanding of the purpose of each component.

 

 

316     PRESENTATION: CHILD AND ADOLESCENT MENTAL HEALTH SERVICES (CAMHS), MRS. R. WHITTLE, COMMISSIONING LEAD – CARDIFF AND VALE CAMHS AND DR. J. DOWNEY, CLINICAL PSYCHOLOGY LEAD – CAMHS NETWORK –

 

The Commissioning Lead for the Cardiff and Vale CAMHS Network commenced the presentation by providing a brief background summary of the situation.  In October 2012, the Welsh Government published a document entitled "Together for Mental Health".  This replaced previous age specific guidelines. 

 

Childhood mental health problems were common, with one in ten children having a diagnosable emotional health problem.  The level of emotional mental health problems in our young population was increasing.  The main increase had not been in severe functional illness but the recognition of stress, anxiety, depression and behavioural issues including risk taking which may develop into enduring problems.  Support required was complicated by the need for a multiagency approach, local authority services, third sector, carers and families.  Education, parenting services and health all had a vital role to play as well. 

 

CAMHS services for children and young people were provided by the Managed Clinical Network hosted by the Cwm Taf Health Board.  They linked closely with child health and adult mental health services provided by the Cardiff and Vale UHB.  The Network provided:

 

·         Primary mental health services

·         Community CAMHS services

·         Community Intensive Treatment Team (CITT)

·         In-patient Tier 4 services to five health boards – as above and Hywel Dda Health Board (HDHB), Abertawe Bro Morgannwg Health Board (ABHB) and lower Powys

·         Forensic Adolescent Consultation Team (FACT) – all Wales.

 

In describing the drivers for change, the Commissioning Lead informed the Committee that the service was relatively small and was facing increased demand.  Health Inspection Wales and Welsh Audit Office reports on CAMHS would help drive the service forward as would children and young people committee reviews.  Ministerial questions and concerns were also a factor, as were complaints from referrers and agencies about delays, referral not being accepted and lack of services.  Increase in admissions via Accident and Emergency was a considerable factor along with the lack of support to specific groups with mental health problems but with no functional mental illness (e.g. Looked After Children, Youth Offending Services and difficult behaviour). 

 

In October 2013, the UHB commenced a work programme to agree a sustainable service model for emotional and mental health services.  It was clear that there were many complex issues with multiple perspectives relating to the need and the service delivery model.  Every partner had a different expectation and perception of what CAMHS and other partners should provide.  The workshop in January 2014 identified five key areas of work to be taken forwards. 

 

The first area related to primary mental health support. Currently, two services were providing different functions, these being the Primary Mental Health Team and the Part 1 Team.  This created confusion among referrers and service users. A main aim of the programme was to create one integrated service combining both functions that included a clear referral pathway. 

 

The second area of work was specific to clients whose behaviour involved risk-taking.  It was considered that this was everyone’s business, not just the specialist CAMHS service.  Young people tended to bounce around the system and not get the help they required.  The programme aim was to develop and implement a multi-disciplinary / multiagency response to support those children and young people where a professional judged that they need urgent assessment and support.  This included those with risky behaviour who today were likely to present at the Emergency Unit.  These young people required:

 

·         mental health assessment / risk assessment

·         a place of safety

·         a multi-disciplinary strategy meeting

·         a risk management plan (including support package).

 

The third aspect of the area of work revolved around specialist NHS CAMHS services.  These are provided to children with an identified psychiatric disorder (e.g. depression, psychosis, ADHD, etc.).  The aim of the programme was to create a clear service specification for the population to enable appropriate commissioning. 

 

The fourth area was around improving links to specialist services at Tier 4.  Currently, the inpatient unit (tertiary service) Wales was based at Ty Llidiard, Princess of Wales Hospital in Bridgend.   When it was built, the unit was made up of two wards, one a 14 bed unit and the other a 5 bed unit.  Presently, only the 14 bed unit was staffed and this provided a discharge liaison service.  The aim of the programme was to work with Welsh Health Specialised Services Committee (WHSSC) to commission and secure the necessary services to meet the needs of the population. 

 

The final area of work related to Service User engagement. It was the aim of the programme for commissioning to be informed by what young people had told the service.  It was important for close working arrangements with third sector partners to run focus groups and, working through partners, to access young people to gather feedback. 

 

A Committee Member raised concern regarding delays in arranging appointments for children to see a consultant and the impact this could have on the young person’s school education.  The Commissioning Lead informed Members that they recognised a number of issues that were raised by the Committee Member and that they had dealt with a number of complaints relating to access.  The service was currently looking at the appropriateness of responses and it was important to recognise mental health issues and the need to look at the whole range of support services available.

 

At this point, the Clinical Psychology Lead advised Members that the availability of services had been affected by the current level of budget cuts.  At present, the service was made up of 12 full time equivalent posts and 5 medical practitioners to cover the whole of Cardiff and the Vale of Glamorgan.  All clients were assigned to the CAMHS service and the new legislation had affected how the service performed. 

 

In response to a query concerning the support of those individuals who may not be appropriate for CAMHS support, the Committee was advised that the Part 1 team was required to provide a brief assessment and provide short term intervention to individuals.  There was a recognised gap for children and young people who suffered with risk-taking behaviours, but the service did not want to negatively label children with a mental health problem.  In essence, the current programme was around unpicking all the pieces of the service and putting it back together and there was a need to evaluate whether adequate resources were available.  There was also a need to look at the population group where the main risk factor had been identified.  However, it was impractical to expect 12 full time equivalent staff members to handle the current level of service demand. 

 

A Committee Member, in referring to previous comments regarding the funding of the service within Wales, sought clarification as to whether there was any evidence to support this view.  The Clinical Psychology Lead stated that they had recently looked at benchmarking for comparable areas and it had been identified that there was a 60% budget deficit compared to areas within England.  The only way to improve the situation was for an integrated and multi-agency approach that worked with all agencies, particularly with schools and youth services.  Further to this point, a Committee Member questioned as to who was responsible for the lack of funding and whether there were any suggestions that would improve the situation.  The Commissioning Lead advised that the funding issue was very well known within Health.  The service needed to undertake a review to assess the resources available. 

 

Following a query regarding the timescales of the programme, the Committee was advised that there was a need to wait for formal feedback, but in terms of providing mental health services there was a requirement to prioritise where the service was best hosted. The service currently worked with all age ranges and the service may need to assess whether it focused on children’s service.  The evaluation of options would be concluded by the end of September and the current work was focused on the risk-taking behaviour of children and young.  This was going to be long and complicated and would include a pilot on a small scale.  There was a need to identify when peak time for demand occurred. The service was aware that many young people appear in A&E between 14:00 and 15:00 hours on a Monday and Tuesday, but the service needed to properly assess what triggered episodes in children and young people. 

 

The Director of Social Services advised that a briefing note will be distributed to Members, outlining the Council’s perspective in respect of the issues raised during the presentation.

 

The Committee expressed a desire for an update report detailing progress to be provided within 12 months’ time. 

 

Having considered the above, the Committee

 

RECOMMENDED –

 

(1)       T H A T the presentation and minutes from this meeting be referred to Cabinet.

 

(2)       T H A T a further update report be presented in 12 months’ time.


Reasons for recommendations

 

(1)       To inform Cabinet of the changes to the CAMHS service and to highlight issues affecting an important service area.

 

(2)       To provide oversight and scrutiny of an important service area.

 

 

317     REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL 2014 TO 31ST JULY 2014 (DSS) –

 

The Operational Manager – Accountancy presented the report, the purpose of which was to advise Members of the position in respect of revenue and capital expenditure for the period 1st April to 31st July 2014.

 

Revenue

 

The current year end forecast for the Social Services budget was an overspend of £800k.  In addition to increased demand for services, there was pressure on the Directorate to achieve its savings targets for 2014/15 onwards. 

 

Children and Young People's Services – This service was currently anticipated to outturn £200k under budget at year end.  The major issue concerning this service continued to be the pressure on the children’s placements budget.  At present, it was currently projected that the Joint Budget for Residential Placements for Looked After Children would outturn within budget at year end.  However, it still remained early in the financial year and therefore this position would need to be monitored closely as any increase in the number of children becoming looked after by the Council over the remainder of the year could have a significant impact on the budget, particularly if they required high cost residential placements.  The areas of projected underspend in the budget were currently legal expenses, adoption income and reduced expenditure as a result of the current cohort of children. 

 

Adult Services – This service was currently anticipated to outturn £1m over budget at year end.  This was due to a projected overspend on Community Care Packages of £1.2m as a result of increased demand for services, particularly for frail older clients.  The service would strive to manage demand, not only to avoid a further increase in the overspend, but also to reduce the overspend.  Whilst every effort would be made to improve this position, it could not be guaranteed that this position would not deteriorate further by year end as this budget was extremely volatile and under great pressure.  The annual deferred income budget for 2014/15 had been set at £725k and at 31st July 2014 it was £58k behind target.  It was therefore being projected that this budget would underrecover by £150k at year end and this position was included as part of the projected overspend on the Community Care packages budget.  The areas of projected underspend in the budget were currently staffing and related travel costs and premises.


Capital

 

Attached at Appendix 2 to the report were details of financial progress on the Capital Programme as at 31st July 2014. 

 

For all schemes where it was evident that the full year’s budget would not be spent during the year, the relevant officers were required to provide an explanation for the shortfall and this should be taken to the earliest available Cabinet meeting. 

 

Appendix 3 to the report provided non-financial information on capital construction schemes. 

 

Social Services Budget Programme Update

 

On 5th March 2014, Council approved the savings targets for 2014/15 and the initial savings targets for 2015/16 and 2016/17. 

 

As part of the Medium Term Financial Plan, approved by Cabinet on 11th August 2014, it was agreed that the service remodelling savings, included in 2015/16 and 2016/17 would be rephased.  These savings were to be found through collaborative working and it was considered that a longer time frame would be required for these savings to materialise in cash terms and therefore the current savings target of £475k in 2015/16 and £495k in 2016/17 were to be re-profiled to £320k in 2017/18, £320k in 2018/19 and £330k in 2019/20.

 

The Directorate was currently required to find savings totalling £3.97m by the end of 2019/20.  The surplus shown was as a result of the foster carer recruitment project and could be used to mitigate any additional savings to be found in future years.

 

The following table shows the approved savings targets and the savings identified by year.  It includes the £293k identified in 2012/13 in excess of the saving target for that year.

 

Year

Savings Required

£000

Savings Identified

£000

In Year Surplus/ (Shortfall)

£000

Cumulative Surplus/   (Shortfall)

£000

Previously Identified Savings

 

293

293

293

2014/15

713

454

(259)

34

2015/16

1,125

1,201

76

110

2016/17

1,162

1,238

76

186

2017/18

320

320

0

186

2018/19

320

320

0

186

2019/20

330

330

0

186

TOTAL

3,970

4,156

 

 

 

Appendix 4 to the report detailed the latest progress for each savings project currently identified. 

 

Specific to the projected overspend within Adult Services, the Head of Adult Services advised the Committee that it was of some concern to be in this position at this current stage of the financial year.  There was a need to fully evaluate and understand the level of risk facing the service.  Budgetary pressures identified within Quarters 1 and 2 were similar to previous years and it had been identified that there was increased demand within older people’s services and for young people transitioning from Children’s to Adult Services.  There was a need for further detailed analysis of the demand for services, similarly to that which had been carried out previously.  Aspects which affected the budget included the £55 cap for the charging of services, the reorganisation within the Health Service and the changes by Health to continuing health care guidance.

 

A Committee Member enquired if there was any way to get the budget plans back on track.  In response the Head of Adult Services advised that this was a difficult undertaking but there was a need to review whether the service had over-provided care.  In response to a query regarding the arrangements regarding contracts for domiciliary care, the Committee was advised this would move away from spot purchase for domiciliary care support for adults in the community, the savings being realised in 2015/16. 

 

RECOMMENDED –

 

(1)       T H A T the position with regard to the 2014/15 revenue and capital monitoring be noted.

 

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

 

Reasons for recommendations

 

(1)       That Members are aware of the position with regard to the 2014/15 revenue and capital monitoring relevant to this Scrutiny Committee.

 

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

 

 

318     SERVICES FOR PEOPLE WITH LEARNING DISABILITIES: COMMISSIONING STRATEGY 2014-2017 (REF) –

 

At its meeting on 30th June 2014, Cabinet had approved the Commissioning Strategy for Services for People with Learning Disabilities for the period 2014 to 2017.  The Strategy had been referred to the Scrutiny Committee for information. 

 

The Head of Adult Services advised Members that the proposed services commissioning strategy identified how the Council would respond to rising demand and changing expectations on the part of adults with learning disabilities and their families within the resources available to the Council.  Production of the Strategy had been an opportunity to further the Council’s overall programme for improving and modernising the social care services provided. 

 

The Strategy contained an analysis of demand, supply and service gaps together with a commissioning plan which set out the operational tasks needed to ensure that the commissioning priorities were achieved.  The Strategy would assist the Council in working in partnership with Cardiff Council and the Cardiff and Vale University Health Board to commission jointly services that deliver high quality care and support that are based on people’s needs and preferences. 

 

The Strategy set out five priorities for the Vale of Glamorgan Council when commissioning services:

 

·         people with a learning disability are supported to maximise their independence

·         people with learning disabilities are supported to play an active role in society and engage in meaningful daytime activities and employment or volunteering

·         people with a learning disability are valued and included within their own communities

·         people with learning disabilities are enabled to stay healthy and safe

·         people with learning disabilities are supported to become lifelong learners.

 

Each of these priorities are then articulated in terms of service implications, where are we now?, what will we do next?, timescales and responsibilities. 

 

In response to a Committee Member’s query regarding how the service model would meet increased demand, the Operational Manager, Learning Disabilities, stated that at present the current population of service users included 350 individuals with a further 51 potentially coming into the service through transition.  She advised that this demand would be managed through detailed assessment of packages with associated high costs. 

 

A Committee Member queried whether the Council was actively promoting direct payments.  In response, the Head of Adult Services advised that the Commissioning Strategy related to learning disability clients and that the Council was planning to re-tender for direct payment providers.  It was anticipated that the level of uptake of direct payments would increase as this became more of a default option for social workers to consider.  Further to this a Committee Member stated that they had recently received a number of complaints regarding people receiving lower level subsidy than that paid by the Authority.  In response, the Head of Business Management and Innovation advised that it was true to say that the hourly rate paid through direct payments was less than that paid by the Council.  The rationale behind this was that agencies would have a number of overheads that individuals did not have and that this would increase each year. 

 

In assessing engagement with service users and feedback, the Committee was advised that the main issue identified had related to gaps within service provision.  A Committee Member enquired as to what forms of communication learning was available for clients with learning disabilities through day service opportunities.  The Operational Manager, Learning Disabilities, advised Members that various opportunities were available through day services and this included an element of choice for individuals.  Demand was relatively low but agencies from within the third sector had been approached in order to improve staff training. 

 

In seeking an update in respect of the changes to the Independent Living Fund (ILF), the Committee was advised that at present the Welsh Government was consulting on three options.  The service had assessed cases where individuals were in receipt of ILF payments in order to address the potential impact.

 

In referring to the person-centred planning approach, a Committee Member questioned the nature of the scheme in allowing individuals to properly choose the type of activity that the grant payment would be allocated for.  In response the Operational Manager, Learning Disabilities advised Members that service users’ activities were no longer simply around packing boxes and that the opportunities offered through day services had been reviewed.  The ability of individuals to choose activities was of critical importance but it was also important to remember that the service had statutory obligations and it was not always possible to meet provision outside those activities that the Council was able to fund.

 

RECOMMENDED – T H A T the Commissioning Strategy for 2014-2017 be noted.

 

Reason for recommendation

 

To ensure that the Scrutiny Committee is able to exercise effective oversight of this key area of activity.

 

 

319     DEPRIVATION OF LIBERTY SAFEGUARDS (REF) –

 

On 28th July 2014 Cabinet had been updated in regard to the implications of a Supreme Court Ruling in March 2014 regarding implementation of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards 2009.

 

On 19th March 2014 the Supreme Court passed judgement on two cases that overturned previous judgements by the Court of Appeal.  It published a revised test for deprivation of liberty safeguards which extended the protection to a wider population of people being cared for in care homes, hospitals and within their own homes.  The effect of these changes provided a substantial increase in the number of people who would require the protection of the Cardiff and Vale Deprivation of Liberty Safeguards (DoLS) or the Court of Protection.

 

Following a query regarding the potential extra cost to the Council, the Committee was advised that during 2013 the service carried out 91 assessments.  So far for this financial year they had already undertaken over 400 assessments.  The change of definition had been taken on board by hospitals and care homes and there were potentially 1,500 individuals likely to be affected by the changes.  Additional costs had been incurred following the additional recruitment of Best Interest Assessors and further costs would result from Section 12 authorisations from general practitioners.  Another significant potential cost related to the application to the Court of protection for individuals within local communities and this could be as much as an additional £250k per year. 

 

Members were also asked to note the potential compensatory payments to clients which had been estimated by Whitelands as being £300 per day per individual. 

 

As a final point, the Head of Adult Services commented that the level of resources was extremely fragile and that new legislative changes significantly impacted upon Care Management time. 

 

RECOMMENDED – T H A T the potential impact of changes to the Deprivation of Liberty Safeguards be noted.

 

Reason for recommendation

 

To ensure that this matter received appropriate oversight from the Scrutiny Committee.

 

 

320     REPRESENTATIONS AND COMPLAINTS IN SOCIAL SERVICES: NEW GUIDANCE FROM WELSH GOVERNMENT (REF) –

 

Cabinet, on 28th July 2014, had been apprised of new guidance and regulations in relation to Social Services Representations and Complaints. 

 

The Head of Business Management and Innovation advised the Committee that the Council’s current Social Services Representation and Complaints Procedure had been in use since 2006.  In November 2013 the Social Services complaints procedure was brought in line with the all Wales "Model Concerns and Complaints Policy and Guidance" issued by the Welsh Government in July 2011 and the NHS Complaints Procedure "Putting Things Right".

 

The current process consisted of three stages as follows.

 

Stage 1: Local Resolution

 

The policy and procedure aimed to ensure that people who complain have their concerns resolved swiftly and, wherever possible, by the people who provide the service locally.

 

Stage 2: Formal Consideration

 

Where a complaint cannot be resolved at Stage 1, it is referred to Stage 2.  An Investigating Officer (who is independent of the service about which the complaint has been made) is appointed by the Director (or his representative) to investigate the matter.  In the case of children's complaints, an Independent Person (not employed by the Authority) is also appointed to oversee the investigation process in accordance with statutory requirements.

 

Stage 3: The Independent Panel

 

Complainants who are dissatisfied with the outcome of the complaint investigation at Stage 2 have the right to have their complaint reviewed by an Independent Panel.

Both the panel membership and the administrative arrangements for the panel are wholly separate and independent from the Local Authority.

 

The key changes within the new guidance are summarised below.

 

·         a twelve-month time limit in which to bring a complaint, unless there are exceptional circumstances;

·         a focus on local resolution initially – complainants are to be offered a discussion to resolve their complaints within 10 days of the complaint being received;

·         an independent investigator has to be independent of the local authority;

·         removal of the Stage 3 Panel - from August 1st 2014, if a complaint or representation is not resolved at the Formal Investigation Stage (Stage 2), the complainant must be advised that they have the right to complain to the Public Services Ombudsman. The Ombudsman's Office will aim to complete all investigations within 12 months: and

·         greater emphasis on learning lessons.

 

The focus of the new procedure was on informal resolution and the regulations require that all those who raise a concern are offered a discussion (either face-to-face or by telephone) in an attempt to informally resolve the matter.  A further major difference was the removal of the independent panel stage.  The new two-stage process is in line with the Model Concerns and Complaints Policy and Guidance and the NHS Complaints procedure, "Putting Things Right".

 

This new approach would result in a more straightforward approach to complaints resolution which was more citizen focused in that the service would concentrate on addressing the issues for the individual rather than on the complaint process itself.

 

RECOMMENDED – T H A T the changes as detailed within the report be noted.

 

Reason for recommendation

 

To ensure that the Scrutiny Committee is informed of the changes.

 

 

321     RESHAPING SERVICES – A NEW CHANGE PROGRAMME FOR THE COUNCIL (REF) –

 

At its meeting on 11th August 2014, Cabinet had agreed to refer the report for consultation purposes. 

 

The Director of Social Services, in presenting the report, advised Members that Central Government’s austerity had created a period of unprecedented financial pressures in the public sector.  The Vale of Glamorgan Council’s budget had already been squeezed for 2014/15, with further substantial savings necessary in 2015/16, 2016/17 and 2017/18.  The latest draft Medium Term Financial Plan estimated that this would equate to a reduction of over £10m in 2015/16 and £32m in total over the next three years.  Failure to deliver the required level of savings would not be an option for the Council.  Accordingly to many analysts, a period of "permanent austerity" was now likely for Councils for the foreseeable future. 

 

It was clear that the scale of the challenge to come would mean that "business as usual", however well managed, would not be enough.  Continued incremental cuts to budgets would simply lead to a steady decline in the quality and availability of public services, dissatisfaction among those who use the services and poor staff morale. 

 

The challenge for the Council therefore was to consider alternative delivery models for services across the board and this was seen as the only way to maintain a broad range of services and to an acceptable standard.

 

Shown under Appendix 1 was the strategy that encompassed the various models for service delivery and how these proposals were to be considered.

 

Focusing upon the implications for Social Services, the Director of Social Services stated that the experience of the last five years demonstrated that the Directorate had, in essence, already put a change programme in place.  The Directorate was already working to integrate health and social care services and was also focused on delivering services via external providers.  He urged caution in respect of causing disruption to service users, particularly in relation to the potential failure of external service providers and the need to maintain resilience within important service areas.  There were some successful examples of social enterprises and working through stakeholder co-operatives in social care, but these examples were few in number.  It was correct that the Council look at opportunities to reshape the services and adopt a corporate approach.

 

A Committee Member commented that the reshaping document had been made available to staff within the Vale of Glamorgan Council and that they were concerned with the potential loss of skill and knowledge if staff considered setting up co-operatives in order to carry out the service in that manner.  In response, the Director of Social Services said that it was important to engage with staff early in the process of change and in generating ideas because they would have to sign up to any changes.  Trade Unions and staff were sometimes reluctant to pursue such ventures, especially when there was strong consideration of maintaining job security.  The Directorate was engaging team managers to gather their ideas and was exploring all possibilities with all the Council’s care providers.  He asked Members to be mindful of examples highlighted in respect of independent foster care, which initially resulted in many Council staff members leaving to work with independent bodies.  There could be adverse effects on cost and quality.  The Council’s and service user interests needed to be protected and it was not always cheaper or more sustainable for commercial bodies to provide services.  The Council needed to think long term and to ensure that the standards and level of care provided could be maintained. 

 

A Committee Member queried as to what more could be achieved, when factoring in all the recent work to remodel services that had already taken place.  The Director of Social Services advised the Committee that service integration with Health may not provide the level of savings expected.  It would improve the experience of clients and service users but the potential to reduce costs on a very significant scale were not necessarily there.  The use of telecare and assisted technology would have potential to change the services to a greater extent, as would local, regional and national working arrangements.  The Vale Council did not necessarily need to provide all services, although the need to factor in service resilience was an important consideration. 

 

RECOMMENDED – T H A T the "Reshaping Services" strategy and change programme be noted.

 

Reason for recommendation

 

To enable the Committee to have oversight of a major Council strategy to reshape services over the next three to five years.

 

 

322     EXTRA CARE HOUSING (DSS) –

 

The Head of Business Management and Innovation, in presenting the report, advised Members that the scheme would provide supported accommodation in 42 affordable homes for rent to people over the age of 55 living in the Vale of Glamorgan and needing care and support.  It would include a restaurant, laundry, hairdresser and a multi-use activity / atrium space.  The front staircase incorporated a feature glass facade designed by an architectural glass artist. 

 

Committee was informed previously that the original contract had been delayed because of changes in the ownership of the building contractor.  The revised completion date for building works was June 2014.  Regular meetings had taken place with Hendre, the development arm of Hafod, to monitor the situation. 

 

Significant progress had been made in recent months but the contractor had informed the Council that there would be a further delay.  Flooding on the site had damaged parts of the building.  As a result, the contractor had requested an extension to the contract to allow for the damage to be repaired and for the final works to be completed to the required standards.

 

Following a recent meeting with Hafod Housing and Hendre, it was now anticipated that the first tenants would move into their new accommodation in September 2014.

 

The Council had recently let two contracts to provide care and support to tenants using this new scheme.  Hafod Housing had been awarded the Supporting People contract, which would provide support and advice for tenants prior to their move and once they were in the property.

 

The domiciliary care contract had been awarded to Reach, which was an organisation based in South Wales.  This contract would deliver support hours to the tenants in the property which were flexible and could change to meet fluctuating needs.

 

The new scheme had generated a great deal of interest, both locally and from further afield.  To date, tenancy offers had been sent to 34 individuals.  The criteria for eligibility were that an individual had to be 55 years or older, a current resident of the Vale and in receipt of social care services.

 

The working group continued to manage the risks associated with such a major enterprise.  The key risk currently concerned completion of the building work.

 

Referring to partnership working arrangements over the extra care facility between Hafod Housing, Hendre and Reach, a Committee Member asked if officers could anticipate any problems.  In reply the Head of Business Management and Innovation advised that no problems could be foreseen.  Hafod had been awarded the contract for the Support People element of the facility and Reach had been provided the domiciliary care element.  Current working arrangements were working very well in respect of the referral process and in deciding the kind of tenancy that people would require. 

 

A Committee Member enquired as to the potential impact upon the budget following the delay in opening the extra care facility.  Members were advised that the budget savings had been remodelled due to the delay and there was a concern as to whether the agreed £75k would be saved. 

 

A Committee Member expressed satisfaction of the success in establishing the extra care facility which was a credit to the service and was looking forward to the project working well. 

 

RECOMMENDED – T H A T the current position with regard to extra care in the Vale of Glamorgan be noted.

 

Reason for recommendation

 

To ensure effective scrutiny of a key function undertaken by the Council.

 

 

323     PROTECTION OF VULNERABLE ADULTS: SIX MONTHLY UPDATE (DSS) –

 

The Committee received a report, the purpose of which was to advise Members of the priorities, challenges and risks associated with the protection of vulnerable adults.  For Members’ information  the Head of Business Management and Innovation drew attention to the Annual Report attached at Appendix 1 and that following the Social Services and Wellbeing Act (Wales) Act introduction of the joint Vale of Glamorgan and Cardiff Adult Safeguarding Board in place of the Vale of Glamorgan Adult Area Protection Committee.  Members were asked to note the increase in referrals during 2013/14 which was as a result of increased awareness of the issues by partner organisations and agencies. 

 

In referring to the changes of the Safeguarding Board, a Committee Member queried whether input was received from the same bodies and organisations.  In response Members were advised that all representatives were part of the new arrangements and that there were probably more representatives involved in the overall work of the Boards following the new arrangements. 

 

The Committee noted that protection of vulnerable adults' information and issues specific to the Vale of Glamorgan would still be reported back to the Committee.

 

RECOMMENDED –

 

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

 

(2)       T H A T information about the work undertaken to protect vulnerable adults continues to be reported to the Scrutiny Committee on a six monthly basis.

 

(3)       T H A T information about the work of the Cardiff and Vale Adult Safeguarding Board be reported to the Scrutiny Committee on a six monthly basis.

 

Reasons for recommendations

 

(1)       To increase awareness of priorities, challenges and risks involved in this crucial area of work.

 

(2&3)  To ensure effective scrutiny of a key function undertaken by Social Services on behalf of the Council.

 

 

324     SOCIAL SERVICES REPRESENTATIONS AND COMPLAINTS – ANNUAL REPORT 2013/2014 (DSS) –

 

The report outlined the activity, performance and achievements in relation to representations and complaints and of the work completed during 2013/14.  Members were asked to note the revised Complaints Procedure and the improvement planned for 2014/15.

 

The Committee was provided with an overview detailing that the number of complaints had dropped slightly, the support to people at an early stage had increased and the response rate of the Council was good. 

 

The key changes within the new guidance are summarised below.

 

·         a twelve-month time limit in which to bring a complaint, unless there are exceptional circumstances;

·         a focus on local resolution initially – complainants are to be offered a discussion to resolve their complaints within 10 days of the complaint being received;

·         an independent investigator has to be independent of the local authority;

·         removal of the Stage 3 Panel - from 1st August 2014, if a complaint or representation is not resolved at the Formal Investigation Stage (Stage 2), the complainant must be advised that they have the right to complain to the Public Services Ombudsman.  The Ombudsman’s office will aim to complete all investigations within 12 months; and

·         greater emphasis on learning lessons.

 

The focus of the new procedure was on informal resolution and the regulations require that all those who raise a concern are offered a discussion (either face-to-face or by telephone) in an attempt to informally resolve the matter.  A further major difference was the removal of the independent panel stage.  The new two-stage process was in line with the Model Concerns and Complaints Policy and Guidance and the NHS Complaints procedure, 'Putting Things Right'.

 

RECOMMENDED –

 

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

 

(2)       T H A T the Scrutiny 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 performance in Social Services and to acknowledge the need for direct evidence of the impact upon individual service users and their carers.

 

 

325     ANNUAL REVIEW OF THE COUNCIL’S ADOPTION SERVICE (DSS) –

 

The Operational Manager, Children and Young People Services, presented the report, the purpose of which was to provide the Scrutiny Committee with an update following the Annual Review of the Vale of Glamorgan Council’s Adoption Service in line with statutory guidance. 

 

Regulation 22 of the Adoption Service (Wales) Regulations 2007 requires all Adoption Agencies, both voluntary and statutory, to complete an annual review of service quality.  The 2013/14 Annual Review for the Vale of Glamorgan Council Adoption Service was attached at Appendix 1 to the report.

 

The Vale of Glamorgan was relatively well placed in its ability to attract and approve adopters in sufficient numbers for its own children.  During 2013/14, the Adoption Service received 29 registrations of interest from prospective adopters, compared to 25 the year before.  The Council increased the number of approved adopters during 2013/14, with nine families (18 individuals) being approved compared to seven families (14 individuals) during 2012/13.  Overall, there had been a decrease of almost 50% in the number of initial enquires made to the Adoption Service compared to 2009/10 data but conversion rates (i.e. the proportion of people registering interest who are subsequently approved) had almost doubled for the same period.

 

Ten children in the Vale of Glamorgan were placed for adoption during 2013/14, the same number as in 2012/13.  Five children were made subject of Adoption Orders during 2013/14, compared to three during 2012/13; it should be noted that adoption orders were not always made during the same year that a child was placed for adoption.  During 2013/14, there was one adoption disruption – a child of 12 years who had been placed with Vale of Glamorgan adopters from the age of three.

 

In referring to the CSSIW’s recommendations that further development work in relation to the child assessment records for adoption documents be improved, the Committee was advised that these were written by child care social workers and that there was some discrepancy in the quality of assessments undertaken.  Extra training had been provided to those staff members and a quality assurance programme had been put in place. 

 

The Chairman, referring to the move to a national adoption agency, queried the potential impact upon the Vale of Glamorgan.  In reply Members were advised that there were two perspectives.  Firstly, the Vale of Glamorgan would be the host authority for a regional adoption service and that this would also sit alongside a national element.  This would result in larger services that were more sustainable and that would be able to monitor more effectively the quality of the service provided.  There would be greater choice in respect of placements for children and there would be less of a need to place children outside of Wales.  This would strengthen sustainability and resilience and also give agencies more choice and options. 

 

The Committee was keen to pass on their thanks and congratulations to the Adoption Service for the good work and improvements that had been made and for a successful inspection following the visit by the CSSIW. 

 

RECOMMENDED –

 

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

 

(2)       T H A T the Committee’s thanks and congratulations are passed on to the Adoption Service.

 

Reasons for recommendations

 

(1)       To provide assurance that the Council’s statutory functions in relation to providing an Adoption Service are fully met, in line with guidance and regulations.

 

(2)       In recognition of the hard work and dedication shown by the service and its members of staff.

 

 

326     ANNUAL REPORT OF THE DIRECTOR OF SOCIAL SERVICES 2013/14 – CHALLENGE VERSION (DSS) –

 

The Director of Social Services advised Members that as part of statutory duties, the Director of Social Services was required by the Welsh Government to produce an Annual Report on the effectiveness of the social care services in the Vale of Glamorgan and on the plans for improvement.

 

A workshop for Members of the Committee had been held in July to discuss with the Director and the Heads of Service the content of the Annual Report and to comment upon any issues raised or identified.  This Committee meeting represented a further opportunity for Members to discuss the Challenge Version and to provide any feedback and comments for the Director and Heads of Service to consider.  So far the Director had received feedback from two professionals within Health and one from an anonymous individual.  The Health comments were generally very positive but it had been highlighted that there was a need to be consistent in respect of terminology. 

 

In response to a Member’s query whether all responses received were positive, the Director of Social Services stated that they had all made interesting reading.  The feedback received anonymously had questioned whether future plans were feasible in light of the severe budget restrictions being proposed and it was felt by the Director that this had been useful in order to refocus and to look again at the Council’s objectives.

 

In referring to page 7 of the Director’s Annual Report, a Committee Member noted that some data was omitted from the charts in relation to 2013-14.  In reply Members were advised that the data had been embargoed by the Welsh Government until 3rd September and the chart would be updated in time for the report to be presented to Cabinet. 

 

Referring to the improvement priorities in respect of deprivation of liberty safeguards, Members questioned whether officers could clarify the position in respect of drafting an operational policy which described the scope and remit of the team that was presented to the team’s steering group in September 2013.  The Head of Adult Services would seek to amend the report to provide clarity. 

 

In conclusion the Director of Social Services thanked Members for their time and input. 

 

RECOMMENDED – T H A T the Director’s Annual Report for 2013/14 – Challenge Version be noted.

 

Reason for recommendation

 

To provide Elected Members with an opportunity to contribute to the challenge process for the Director’s Annual Report 2013/14.