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SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)

 

Minutes of a meeting held on 9th March, 2015.

 

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

 

 

949     APOLOGIES FOR ABSENCE -

 

These were received from Councillors Mrs. R. Birch and Ms. K.E. Edmunds.

 

 

950     MINUTES -

 

RECOMMENDED - T H A T the minutes of the meeting held on 2nd February, 2015 be approved as a correct record.

 

 

951     DECLARATIONS OF INTEREST -

 

No declarations were received.

 

 

952     REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL, 2014 TO 31ST JANUARY, 2015 (DSS) -

 

The Head of Finance presented the report, the purpose of which was to update Members on the position in respect of Revenue and Capital expenditure for the period 1st April, 2014 to 31st January, 2015. 

 

The report highlighted that, in setting the Social Services budget for 2014/15, the use of £2.199 m from the Social Services budget had been approved. 

 

Revenue

 

In respect to Revenue, the current end of year forecast for the Social Services budget was an overspend of £100,000. A table and graph setting out the variance between profiled budget and actual expenditure to date was attached at Appendix 1 to the report.

 

Within Children and Young People’s Services there was currently an anticipated outturn of £500,000 (3.5%) under the Children’s Services budget at year end.  The major issue concerning this service continued to be the pressure on the Children’s Placement budget.  However, it was currently projected that the joint budget for Residential Placements for Looked After Children could outturn with a £100,000 underspend at year end.  Work had been ongoing to ensure that children were placed in the most appropriate and cost effective placements but, due to the high costs of placements, the outturn position could fluctuate.  There were potential underspends elsewhere within Children’s Services related to team budgets of £80,000, £50,000 relating to administration staff, £50,000 on legal expenses, £60,000 due to additional adoption income and £150,000 on alternative means of provision and accommodation costs required for the current cohort of children.

 

For Adult Services, this service was currently anticipated to outturn £600,000 (1.6%) over the Adult Services budget at year end.  This was due to a projected overspend of £800,000 (3.4%) against the Community Care Packages budget.  This was as a result of increased amount of services, particularly for frail older clients.  While this overspend for this year had reduced, pressures on this budget would continue into the next financial year as the full year effect of current packages would result in a predicted increase in expenditure of around £1m.  The service would strive to manage demand, which would be supported by the reorganisation of the Care Management Team and the implementation of changes as a result of the Intermediate Care Fund (ICF) and the Regional Care Fund (RCF) schemes.  The Annual Deferred Income Budget for 2014/15 had been set at £725,000.  As at 31st January 2015, income received was £39,000 below the anticipated targets and so the year-end projection had been maintained at a £100,000 under recovery.  This position was included as part of the projected overspend on the Community Care Packages budget.  There were potential underspends elsewhere in Adult Services of around £200,000 which could be used to off-set this position.  These areas were £135,000 on staffing, £20,000 on transport, £30,000 on premises and £20,000 on supplies and services. 

 

The RCF grant had been approved for 2015/16, but the amount available was 46% less than that previously indicated by the Welsh Government.  This funding covered five schemes across the collaborative region of Cardiff and the Vale, covering a number of local government functions.  The proposal for the revised allocation of schemes had been submitted to Welsh Government for consideration.  The allocation of grant to schemes had been based on priorities and the availability of other funded sources and so the reduction had not been consistently applied across all schemes.  The original allocation for remodelling Adult Social Care was £650,000 and the proposed allocation from the reduced funding was £533,000. 

 

In relation to the ICF grant, the Head of Adult Services was asked to provide an update. He advised that an amount of £50m had been made available by the Welsh Government for both revenue and capital spends. However, this money was only available for 2014/15.  Welsh Government had recently announced that an additional £20m would be made available to the NHS, to take forward schemes which had proven to be effective across community and acute environments, linking out of hospital care and social care to strengthen the resilience of the unscheduled care system.  Presently, it was unclear how this funding would be allocated.  He was also able to advise that the Local Health Board had agreed to fund the Contact Centre for three months while these future funding arrangements were clarified.

 

Capital

 

Regarding Capital programmes, Appendix 2 to the report detailed financial progress as at 31st January, 2015, while Appendix 3 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 had been agreed that the service remodelling savings included in 2015/16 and 2016/17 would be rephased and were now set as £320,000 in 2017/18 and £320,000 in 2018/19 and £330,000 in 2019/20.  By the end of 2019/20 the Directorate was required to find savings totalling £3.97m.  At present total identified savings amounted to £4.156m, with the surplus as a result of the Foster Care Recruitment Project which could be used to mitigate any additional savings to be found in future years. 

 

The following table detailed the approved savings targets and the savings identified by year.  It includes the £293,000 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

 

 

 

Contained at Appendix 4 of the covering report was further detail in respect of progress for each individual savings project. 

 

Finally, the report highlighted that Cabinet had considered the Council’s Reshaping Services Change Programme on 26th January, 2015.  The report to Cabinet acknowledged that the Social Services Directorate already had two major initiatives underway.  These were the Collaborative Working Programme and the Budget Programme.  These programmes already contained projects which were progressing the opportunities identified as part of the Reshaping Services Programme and savings targets were already included in the budget programme. 

 

In referring to the changes to the ICF Grant, the Chairman queried as to what was the likely impact upon staffing within the Directorate.  In response, the Head of Adult Services explained that health had committed to provide three months funding for the Contact Centre.  The service was awaiting further clarification in respect to other projects within the ICF Grant Scheme but the Directorate had been offered reassurance from health that they were committed to looking at all schemes over the next few months.  Further to this, the Head of Business Management and Innovation advised the Committee that interim health funding had also been secured for the ICF housing services project that would target people awaiting discharge from hospital.  She went onto explain that it was important to recognise that ICF funding was made available on a regional basis and it was not always easy to determine if funding would be agreed. 

 

A Committee Member asked for clarification in relation to the progress around the Looked After Children Residential Care Placement Project.  In response, the Head of Children and Young People Services advised Members that the service had faced some challenges with a number of sibling groups becoming looked after, as well as trying to manage the front end of the service.  The residential unit within Gladstone Road was up and running and a second unit, in a more rural setting, was due to open sometime during April.  The service had decided to review its requirements before committing to the creation of a third residential unit.

 

In answer to a query regarding the Capital Receipts from the sale of Woodlands Road and the ATC Centre, the Committee was advised that unless the Council had specifically decided to earmark the funds to go back into the Social Services Budget, Capital Receipts from the sale of surplus assets would be apportioned back to the corporate centre.  The Committee noted that the only projects where it had been agreed funds would be earmarked for Social Services were the Gardenhurst and the Bryneithin sites. 

 

The Chairman asked for further clarification regarding the three Flying Start projects for which Welsh Government funding had been granted.  The Head of Children and Young People Services explained that the service was not likely to spend all the money within the agreed timescales, particularly in relation to projects within the Colcot and the Red Robin sites.  The Welsh Government had visited both sites and was aware of the delays and possible slippage.  She went on to advise Members that, the Colcot project had been affected by problems with drainage at the site and a delay in the delivery of the pre-fabricated building.  In respect of the Red Robin site, implementation of this project has been delayed due to an issue with the glass roof.  The managers had been in contact with the Account Manager within Welsh Government so that funding for these projects could continue beyond the agreed timescales.  A response to the Service’s application was awaited. 

 

A Committee Member in referring to the Care Packages budget reduction savings programme queried whether there would be any cuts to the support offered to carers.  The Head of Adult Services advised that it was not the service’s intention to cut support to carers. 

 

In summary of the progress within the Revenue and Capital Budgets, the Chairman stated that the service appeared to be on target but there was a considerable issue in respect to the ICF grant monies. 

 

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 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.

 

 

953     SERVICE PLAN 2015/19: SOCIAL SERVICES (DSS) -

 

The Committee received the report the purpose of which was to present the Social Services’ Service Plan for 2015/19.  In summarising the contents of the report, the Director of Social Services advised Members that Appendix A contained the Social Services’ Service Plan in which key areas of note were as follows:

  • Our Service Plan 2015/19 (pages 5 - 31): This section sets the context for the Directorate's Service Plan and identified its key challenges over the coming years.
  • Our Service Self-Assessment (pages 32 to 42): This section highlights how the service was performing and what had been achieved during the previous year. It informs areas for improvement in the coming year. Much emphasis continued to be placed on strengthening the use of benchmarking / comparative data as well as highlighting good practice where relevant. In terms of what had been achieved, the service continued to encourage a more consistent approach in identifying the outcome/impact for the customer/citizen. These issues had previously been highlighted as an area of development by the Wales Audit Office in its Annual Improvement Report of the Council (2013/14).
  • Our Service Outcomes and Objectives (pages 43 to 46): This section confirms the Directorate's service outcomes and objectives (including its contribution to corporate priorities), having considered its key service challenges and the self-assessment.
  • Appendix 1 (pages 47 to 57) contains the Directorate's Service Improvement Action Plan for 2015/16 aligned to each service objective.
  • Appendix 2 (pages 58 to 72) which contains the service's performance measures was incomplete currently as end-of-year data for 2014/15 was not yet available at the time of reporting to the Committee. Following a review by officers, performance measures for 2015/16 onwards will be presented to all Scrutiny Committees for discussion and agreement during July 2015.
  • Appendix 3 (page 73) details the Directorate's workforce requirements.
  • Appendix 4 (pages 74 to 75) provides a breakdown of the savings required for the Directorate over the next three years.

Referring to Service Objective No. 1 detailed within page 39 of the Service Plan, a Committee Member queried whether the 321 referrals to the FACT team related to referrals that were received or accepted.  The Head of Children and Young People Services agreed to review this and amend as necessary. 

 

The Committee Member then commented that it was difficult to understand the wording of the action detailed within SS/A061 and he asked if this could be reworded.  In response, the Head of Adult Services agreed that this was fairly difficult to understand and this would be looked into. 

 

The Committee, in referring to the development of a Dementia Resource Service outlined within action SS/A066, queried as to what were the expectations and what would this look like to individuals.  The Head of Adult Services advised that it would be likely that the day services would be reconfigured in order to help develop a Dementia Resource Service. An amount of £45,000 had been provided through the ICF Grant and this would be used to develop the service at Rondel House.

 

In answer to the Committee’s query regarding the development of the 'Together for Mental Health Delivery Plan’, the Head of Adult Services advised that the service would not have had a direct influence to the development of previous plans as this was mainly health led.  However, new Welsh Government objectives had made it clear that the Local Authority would be expected to take point responsibility for promoting good mental health among the population.

 

A Committee Member queried as to what would be achieved and how long would it take for the delivery of actions identified within the Implementation Plan to meet requirements for the Social Services Wellbeing Act as detailed within action SS/0A069.  In response, the Head of Business Management and Innovation stated that a Programme Manager had been appointed by means of the Transforming Social Care Grant and she was leading on this area of work which would be delivered on a regional basis.  An Implementation Plan was being devised and the Programme Manager would be expected to oversee delivery on behalf of the region (i.e. the Vale and Cardiff).  The service would need to consider future funding of the Programme Manager post in order to make this a longer term appointment.  At this point, the Director of Social Services advised Members that Welsh Government had indicated its intention to allocate the Transforming Social Care Grant by means of the Revenue Support Grant in due course and so he was able to offer some reassurance that there would be money available to implement these actions. 

 

In referring to plans for the development of an Older People’s Village, as highlighted within action SS/A010, the Committee was advised that following the termination of the contract with Hafod around two residential care homes, the service would have greater flexibility with regard to what support would be made available in the future.  A roadshow would be held during March in order to identify what older people want and what the model of “accommodation with care†might look like.  This would help accelerate the project, which was being backed by the Wales Co-operative Centre. 

 

The Chairman referring to action SS/A007, stated that he had recently been able to attend a 'Family Achieving Change Together’ Panel in which he noted that in around half the cases some form of domestic abuse had been identified.  He was concerned whether the actions to ensure a co-ordinated, preventative and early intervention service to families was as holistic as it should be.  In response, the Head of Children and Young People Services advised that domestic abuse within referrals was common and she alluded to changes within the police referral form which allowed for the collection of more detailed information.  MARAC was an important element of the strategy to bring agencies together, of which Children’s Services was a key part.  Further to this point, the Director of Social Services advised that a new police system had been developed in order to track and identify electronically what happens within cases of domestic abuse.  This would allow agencies to be better able to identify families at most risk and lead to appropriate actions being taken.

 

The Chairman then queried as to why there were no actions in relation to the foster care recruitment strategy and around the creation of a regional foster care agency.  In response, the Director of Social Services advised that in terms of the regional foster care agency this may be a bit premature and that the South East Wales Improvement Collaborative was currently looking at best practice so this was still ongoing.  The Welsh Government was keen for all local authorities to adopt common national standards and framework; it was important for the service to see what outcomes would come from these proposals.  The Head of Children and Young People Services confirmed the foster care recruitment strategy remained a priority for the division.

 

A Committee Member, in referring to future integration of services, queried as to whether all partners were as keen as the Council for closer links.  In response the Head of Adult Services advised that most partner agencies were keen for further integration, particularly where it was demonstrably in the interest of service users and patients to do so.  The service would build in further integration for some functional areas, but there was a need to be careful that integration did not create disconnect in other service areas. There was a need for plans to be carefully considered.  In service areas where integration was most appropriate, things were working well within the Vale of Glamorgan when compared to neighbouring authorities.  The Committee also noted that partnership working did bring some challenges but that the governance arrangements within the service were right and this allowed the service to develop a good foundation.  The Director of Social Services stated that it was the Council’s wish to work with both the Third Sector and the commercial sector; this was key to reshaping services.  He also advised that some key partners had not been so quick to react to emerging Welsh Government policies due to some of their own problems and issues.  For him, the Vale of Glamorgan was a good partner to work with, one that delivered on its commitments as shown by our track record.  Across Wales as a whole, there was good progress being made in delivering some good regional and integrated services, perhaps especially in North Wales and the Gwent Authorities.  The Vale of Glamorgan would always be prepared to learn from other Authorities within Wales and would also be keen to progress new projects as they come on line and the Committee noted the example of the proposed National Case Management IT system. 

 

The Committee Members were advised that, following changes to interpretation of the Deprivation of Liberty Safeguards, the number of cases within the Vale of Glamorgan had risen and this had created significant budgetary pressures: a report would be presented to the Scrutiny Committee in due course. 

 

A Committee Member queried as to why 27% of staff sickness was related to stress and whether any further investigatory work should be conducted around this.  In response, the Head of Business Management and Innovation commented that the service would proactively support staff.  Individuals have been referred to Occupational Health or counselling services and support plans have been put in place.  She stated that there had been an increase in the number of people experiencing home related stress and this was something difficult for the Council to address other than the use of counselling services.  She went on to explain that stress could be very personal but within Social Services staff supervision was the norm.  Some individuals would be more willing to share personal difficulties affecting their work than others and it was difficult to identify the problem earlier unless it directly impacted upon a person’s work. 

 

The Committee Members were keen to pass on their thanks to the staff within Social Services for the delivery of an extremely useful and thorough Service Plan. 

 

Having considered the Plan it was

 

RECOMMENDED -

 

(1)       T H A T the Social Services’ Service Plan for 2015/19 be endorsed.

 

(2)       T H A T the Committee’s thanks and appreciation be passed on to members of staff.

 

Reason for recommendation

 

(1)       To confirm the Service Plan as the primary document against which performance for Social Services will be measured and to meet self-assessment requirements under the Local Government (Wales) Measure 2009.

 

(2)       In order to pass on the Committee’s thanks.

 

 

954     QUARTER 3 SOCIAL SERVICES PERFORMANCE REPORT 2014-15 (DSS) -

 

The Social Services performance results for Quarter 3, 1st October to 31st December, 2014 were presented before the Committee with the overall performance of the Directorate detailed at Appendix 1. 

 

In presenting the report, the Director of Social Services advised Members that Service Plans were designed to focus on the achievement of key objectives within each Directorate which in turn would contribute towards the achievement of identified outcomes within the Corporate Plan 2013-17, the Outcome Agreement 2013-16 and the Improvement Plan Part 1 2014-15. 

 

Overall, Social Services was well on track to achieving the objectives contributing to its service outcomes, with 93% of actions currently either completed or on track during the quarter.  Of the 14 Corporate Plan actions within the Service Plan, 100% were either completed or on track. 

 

Of the 9 actions relating to the Improvement Objectives, 22% (2) were completed and 78% (7) on track.  There were currently no actions relating to the Outcome Agreement. 

 

Of the 59 performance indicators, 76% (45) met or exceeded targets, 17% (10) were within 10% of target and 7% (4) had missed targets by more than 10%. 

 

In terms of exceptional performance the report highlighted the significant improvement within the Directorate’s performance in relation to the percentage of children looked after during the year who had a Personal Education Plan in place within 20 days of entering care or joining a new school in the year ending 31st March.  This figure had increased from 40% in 2012/13 to 96.55% this quarter.  The end of year performance for this indicator would be reported in the next quarter. 

 

The report also highlighted that there were only two areas of slippage which were as follows:

  • There had been no further progress made with two statutory partners in relation to developing and agreeing governance arrangements for the Mental Health Service in order to clarify accountability, management, financial and HR issues (SS/A054).  However, a community review had commenced.
  • A Local Delivery Plan was in place for the development of a health led strategy for Mental Health services in partnership with Cardiff Council and Cardiff and the Vale University Health Board; however, the Health Board had not yet developed a Commissioning Strategy (SS/S055a).

The Chairman, in querying the two areas of slippage, was advised that in essence these were one and the same.  The first slippage related to a service ambition for a formal agreement around mental health services within Cardiff and the Vale.  Welsh Government guidelines indicated that a strategy should be in place in terms of integration, but the Cardiff and Vale Local Health Board had struggled with this.  A Community Review had commenced and the Social Services Wellbeing Act should encourage things to be progressed.  In relation to the second area of slippage, the Committee noted that this was an area led by health as they were the more prominent service purchaser.  Unfortunately, some aspects of the health response around progressing the delivery plan for mental health services had been disappointing.  Further to this, the Director of Social Services advised that the Future Generations Bill may make this joint planning across health and social care a more coherent statutory requirement. 

 

In seeking clarification of performance indicator OA3/M26 (Rate per 1,000 population of those 65s who have had a UA assessment) as detailed within page 19 of the Appendix, the Members were advised that the full year estimate was missing from the report and this would be e-mailed to Members in due course. 

 

A Committee Member, in querying performance indicator SS/M003e (the average number of working days between initial enquiry and completion of the care plan, for non-specialist assessments), was advised that it would be more useful for evaluation of performance to be conducted over a longer period of time.  The Committee noted that an integrated assessment form had been developed with the Cardiff and Vale Local Health Board as a way to improve how information was shared.

 

In reference to Outcome Agreement Measures OA3/M26 and OA3/M27, Members were advised that previous targets submitted to Welsh Government had been miscalculated and that discussions had been ongoing with the Welsh Government in order to amend the target settings.  The Committee noted that the Welsh Government team responsible for the management of the Outcome Agreement Measures had lost a number of staff members and so dialogue had been difficult.  The service has made the decision to change the target settings accordingly. 

 

The Chairman, referring to exceptional performance as identified through the percentage of children who are looked after during the year who had a Personal Education Plan in place, asked whether the Committee Members could be provided with a bit more explanation around this and as to whether the service performance would be maintained.  The Committee was advised that a lot of this was down to the input of the Council’s LAC Education Co-ordinator and in particular to the changes made to the template.  In addition, a lot of work and time had been spent with social workers and schools around the development of Personal Education Plans. The service had been able to maintain its performance through to Quarter 3 and would continue to review how this improvement could be maintained. 

 

RECOMMENDED -

 

(1)       T H A T the performance results and any remedial actions to be taken to address service underperformance be noted.

 

(2)       T H A T the progress to date in achieving outcomes as outlined in the Corporate Plan 2013-17, the Outcome Agreements 2013-16 and the Improvement Plan Part 1 2014-15 be noted.

 

Reasons for recommendations

 

(1)       To ensure the Council is effectively assessing its performance in line with the requirement to secure continuous improvement outlined in the Local Government (Wales) Measure 2009.

 

(2)       To consider the Quarter 3 Social Services performance results as at 31st December, 2014 in order to identify areas for service improvement.

 

 

955     IMPROVEMENT PLAN PART 1 (IMPROVEMENT OBJECTIVES 2015/16) (DSS) -

 

The Director of Social Services presented the report the purpose of which was to seek Members’ endorsement of proposed Improvement Objectives for 2015/16. 

 

The report outlined that the Corporate Plan was a key means of the Council in complying with the Local Government (Wales) Measure 2009 which required the Council to set Improvement Objectives annually and to demonstrate continuous improvement.

 

The Corporate Plan 2013-2017 was approved by Cabinet on 25th February, 2013 following extensive consultation with key stakeholders and partners.  The Plan detailed a four year vision for the Council, structured around 8 priority outcomes which reflected the priority outcomes in the Community Strategy 2011-2021.  These outcomes would also reflect the Service Plans for 2015-16 and have informed the governance of service outcomes and objectives.  The proposed Improvement Objectives and associated actions for 2015/16 would reflect the 8 priority outcomes in the Corporate Plan, which would ensure the Council was focussing on areas in need of the most improvement. 

 

Service Plans for 2015/16 incorporated a comprehensive self-assessment and these had also informed proposed Improvement Objectives for the same period.

 

For 2015/16, 5 Improvement Objectives were proposed.  These include 3 current objectives that were carried forward from 2014/15 which were long term strategic priorities for the Council.  Additionally, one further objective had been amended and carried forward to reflect an area of focus for further improvement in 2015/16.

 

Appendix 1 outlined the proposed objectives for 2015/16 and provided a rationale for each objective.  Measures to be undertaken to make a difference were identified including their Lead Officer at a Chief Officer level with responsibility for ensuring the achievement of key outcomes. 

 

Proposed Improvement Objectives for 2015/16 were:

  • Objective 1: To deliver sustainable services including alternative methods of delivery as part the Council’s Reshaping Services Change Programme.  [New]
  • Objective 2: To support more people towards independence.  [Carried forward]
  • Objective 3: To support and enhance the town centres of the Vale of Glamorgan for the benefit of residents, visitors and businesses.  [Carried forward]
  • Objective 4: To reduce the number of young people who are not in employment, education or training (NEET).  [Carried forward]
  • Objective 5: To support and challenge schools in order to improve pupil attainment levels at Key Stages 2, 3 and 4.  [Proposed amendment: To reduce the achievement gap between pupils in receipt of free school meals and those who are not.].

Objective 2 applied specifically to this Committee however the work of the committee would also contribute towards objectives 1 and 5.

  • Objective 1: To deliver sustainable services including alternative methods of delivery as part of the Council's Reshaping Services Change Programme.
  • Objective 2: To support more people towards independence.
  • Objective 5: To reduce the achievement gap between pupils in receipt of free school meals and those who are not.

The Council would be required to consult on improvement objectives and proposed objectives would be published on the Council’s website during March 2015 inviting comments from the public.  At the same time, Members would also be consulted via Scrutiny Committees as would other key stakeholders including the Local Service Board, Town and Community Councils, voluntary sector organisations and local businesses.  Proposals would be made to Cabinet based on the findings from the consultation exercise.  Improvement Objectives would be revised to reflect relevant Cabinet amendments and would be considered by Full Council in May 2015.

 

The Chairman, in referring to Objective 2, queried as to what exactly was meant by the term ‘business organisations’ and if some examples could be provided.  In response, the Director of Social Services explained that this would cover a wide range of organisations that would include independent care and support providers. He cited the example in which an independent care provider had agreed to change to provide a domiciliary care service more targeted on re-ablement service. 

 

A Committee Member queried whether the performance indicators which had been identified in order to measure progress were appropriate and relevant.  In answer to this, the Head of Adult Services explained that the two indicators, which were calculated per 1,000 population, on their own would not necessarily provide useful information.  However, together they would show that the service was reducing the number of people supported in care homes and was increasing the rate of older people supported within the community.  Together these showed that the strategy was working and that intervention services were reducing the need for inappropriate institutionalised care and encouraging people to live more independent lives.  It was also important to recognise that the community indicator was not rising as much as the rate of population within this demographic and this was an indicator of good financial management.  A Committee Member queried whether the Directorate was happy to be judged on these performance indicators.  In response, the Head of Adult Services advised that the Directorate had to come up with a range of indicators to measure progress.  From his perspective he liked indicators relating to response times but even then these would not indicate how well care was being provided.  At this point the Director of Social Services advised that these would only paint a partial picture and that would be why it was useful for the Committee to be presented with other reports which were more qualitative such as service representations and complaints, case examples, inspection reports, etc. 

 

In response to a query regarding the impact of extra care within the Vale, the Head of Business Management and Innovation stated that this was part of the Older Person’s Accommodation Review looking at what sort of services older people would want.  The service had received good feedback from people living within extra care facilities and there were hopes to develop this further. 

 

In relation to Objective 5 and specifically the impact on Looked After Children, the Committee was advised that the main focus of this objective would be in relation to school attendance and Personal Education Plans in order for schools to keep abreast of pupil attainment.  The service would closely monitor the Personal Education Plans.  It had been identified that performance within Key Stage 4 had improved but, as in previous years, this would depend on the cohort of children.  The Director of Social Services stated that Looked After Children would be the focus of a national summit of local authorities to be held this week.  He praised the allocation of £5m from the Big Lottery Funding to improve the care experience for Looked After Children across Wales.  The Vale of Glamorgan in that respect would be well placed as all Looked After Children were being cared for because they needed to be and because the service had a relatively manageable size of Looked After Children population. 

 

Having considered the Improvement Objectives, the Committee subsequently

 

RECOMMENDED - T H A T the proposed Improvement Objectives for 2015/16 be endorsed.

 

Reason for recommendation

 

To ensure the Council identified its key annual improvement priorities for 2015/16 in line with requirements of the Local Government (Wales) Measures 2009.

 

 

956     ASSISTIVE TECHNOLOGY AND DEMENTIA CARE TASK AND FINISH GROUP OF THE SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH) (DR) -

 

The Scrutiny Committee (Social Care and Health) set up the Task and Finish Group in order to examine the potential contribution assistive technology could provide in the development of a dementia supported community in the Vale of Glamorgan to enable people to live independently. 

 

The Group’s objective and purpose was to assess whether the greater use of assistive technology could enable people to live more independent lives for longer and also to consider the effect this could have on the quality of life for those who care for those experiencing dementia. 

 

The report attached at Appendix A contained 15 recommendations (as detailed at page 6 of that report) and 23 improvement actions had also been identified as contained within Appendix E to the actual report.

 

Members of the Group were able to consider and review a wide range of evidence and sources.  These included:

  • the organisation and structure of the Telecare Service
  • the demonstration of equipment and devices available
  • evaluation of a Telecare referral and assessment process
  • assessment of the impact of TeleV+ packages
  • changes to the Supported People Services
  • understanding the perspective of carers
  • Carmarthenshire County Council Telecare service
  • the use of ICT
  • Reminiscence therapy
  • Cardiff and Vale Local Health Board future development of Assistive Technology Strategy
  • regional / collaborative working
  • voluntary and private sector partnership business models
  • analysis of evaluation into the effectiveness of Assistive Technology
  • financial matters.

In addition, the Group were extremely fortunate in being able to meet with a husband and wife who had been directly affected by dementia.  From this, the Group was able receive invaluable knowledge and experience.  The Group also undertook a site visit to the University Hospital in Llandough in order to review the form of Reminiscence therapy carried out at the hospital. 

 

The report highlighted that during the course of the review, the Task and Finish Group was able to complete a thorough investigation into the potential for Assistive Technology in aiding the independent living for people experiencing dementia.  From this, a number of recommendations were made, aimed at improving the responsiveness of the service.  It was recognised that there was a requirement for further work before any major decisions could be taken in relation to the longer term planning of the service. 

 

The Group concluded that Assistive Technology could be of considerable help to people experiencing dementia and also to their carers.  However, national research, information from partners and data from our existing service was not sufficiently clear to suggest that Assistive Technology was likely to deliver savings.  Of these significant budgetary pressures that the Council faces, the Group had made recommendations for improvements which it was hoped were realistic and measured, and that identified the further work required to develop the service for the future. 

 

The Head of Adult Services advised the Committee that this was an area of the service that had needed to be developed.  The service was relatively small in numbers and the service was unsure of its direction.  A thorough and honest review of the service had been undertaken with no areas hidden and everything had been covered.  This included a very complex financial picture which highlighted that the research available was unclear.  The Task and Finish Review provided the service with a new level of perspective and clarity and the current Service Plan was committed to a number of the Task and Finish Group’s recommendations.  These recommendations were realistic and grounded and a positive action plan had been developed.  Finally, he offered his thanks and appreciation to Members of the Task and Finish Group. 

 

The Vice-Chairman of the Committee stated that at the beginning of this Review into Telecare she was not fully convinced of the usefulness of the technology available.  However, from speaking to and hearing the perspective of carers she fully appreciated how Assistive Technology could be a useful aid to people experiencing dementia and particularly for their carers.  She stated that a lot more work needed to be undertaken on the financial side and she offered her thanks and appreciation to all involved. 

 

A Committee Member, also a member of the Task and Finish Group, expressed his appreciation at being part of the Group and thanked all those who took part and provided evidence. 

  

RECOMMENDED -

 

(1)       T H A T the report, recommendations and the Action Plan of the Task and Finish Group as detailed at Appendix A to the report be accepted and referred to Cabinet for approval.

 

(2)       T H A T, subject to Cabinet approval, the Scrutiny Committee receive an update on the delivery of the Action Plan within 12 months.

 

Reasons for recommendations

 

(1)       To apprise Members and seek Cabinet approval.

 

(2)       In order that Members of the Scrutiny Committee can monitor progress.

 

 

957     PROVISION OF OLDER PEOPLE’S RESIDENTIAL CARE - HAFOD CONTRACTS AND LEASE (REF) -

 

Cabinet on 9th February, 2015 approved plans to terminate the contract with Hafod Community Care for the provision of older people’s residential care in the Vale of Glamorgan.

 

The report outlined that in 1991 the former South Glamorgan County Council entered into 25 year contracts and leases with Hafod Community Care in relation to 10 older people’s residential care homes.  Of these, two - Ty Dyfan and Ty Dewi Sant - were located within the Vale of Glamorgan.  Following the reorganisation of local government in 1996, the contracts relating to the two homes were transferred to this Council to be managed.

 

The terms of the agreement in 1991 were as follows:

  • Under the terms of the Leases to Hafod, the Council received a lease rental payment and
  • The staff group in the homes were employed by the Council and Hafod makes a contribution to these staffing costs, although this did not meet the full costs.

The two long term arrangements - care management contracts and lease - were due to end in July 2016.  The Council had sought legal advice in relation to this contract as the working of the current contract was financial disadvantageous to the Council.  Discussions took with Hafod to renegotiate the terms of the contract, but at the time Hafod were not willing to look at either the placement fees or the level of reimbursement given to the Council regarding staffing costs.

 

Discussions had been ongoing with Hafod about bringing to an end the current contracts for leases regarding Ty Dewi Sant and Ty Dyfan.  Via the Council’s Legal Services Section, formal communication had been made stating the Council’s intention to bring the current contracts to an end before the official date of July 2016.  There were confirmed in meetings with Hafod held during September and November 2014.  Since that time, negotiations had continued as both parties acknowledged that the contracts and leases would be terminated early if terms could be agreed. 

 

The financial details of the negotiations were contained in a Part II report.  Both parties had been able to agree terms that would enable the contract to end on 31st March, 2015.  Under the terms of this agreement, the management of the two homes would wholly revert to the Council from April 2015 the leases would be surrendered. 

 

The Social Services Budget Programme had included a requirement to negotiate the agreement with Hafod with regard to the two older people’s homes.  This agreement would result in significant savings as set out within the Part II report.  If the agreement was not approved, Social Services would be required to find alternative savings to ensure a balanced budget.

 

The staff in the two homes are employed by the Council and so there would not be any TUPE implications as a result of this proposal.  Most importantly, it was anticipated that the residents and their families would not experience any disruption in care or any reduction in quality.

 

In accordance with legal requirements, the homes would have to be registered with the Care and Social Services Inspectorate for Wales to operate. As Hafod currently held this registration, the Council would apply to take this over.  No problems were envisaged with this application as the Council was already registered to provide care in two other other people’s homes in the Vale. 

 

The Head of Business Management and Innovation provided Members with some reassurance that the residents within the homes would see very little change as staff within the homes would still be managed by the local authority and all processes in place were our own. 

 

RECOMMENDED - T H A T the Cabinet decision to terminate the contract with Hafod Community Care for the provision of older people’s residential care in the Vale be noted.

 

Reason for recommendation

 

In order to endorse Cabinet’s decision.

 

 

958     EXCLUSION OF PRESS AND PUBLIC -

 

RESOLVED - T H A T under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following items of business on the grounds that they involve the likely disclosure of exempt information as defined in Part 4 of Schedule 12A (as amended) of the Act, the relevant paragraphs of the Schedule being referred to in brackets after the minute heading.

 

 

959     PROVISION OF OLDER PEOPLE’S RESIDENTIAL CARE - HAFOD CONTRACTS AND LEASES (REF) (EXEMPT INFORMATION - PARAGRAPH  14) -

 

The Scrutiny Committee was provided with details regarding the terms negotiated for terminating the contract with Hafod Community Care for the provision of older people’s residential care in the Vale. 

 

RECOMMENDED - T H A T the Cabinet decision to terminate the contracts and leases with Hafod Community Care for the provision of older people’s services at Ty Dyfan and Ty Dewi Sant be endorsed.

 

Reason for recommendation

 

To endorse Cabinet’s decision.

 

 

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