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SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)

 

Minutes of a meeting held on 8th September, 2015.

 

Present:  Councillor R.L. Traherne (Chairman); Councillors R.J. Bertin, H.C. Hamilton, Dr. I.J. Johnson, J.W. Thomas and S.T. Wiliam.

 

Also present: Councillor S.C. Egan

 

 

366     APOLOGIES FOR ABSENCE – 

 

These were received from Councillors Mrs. M.E.J. Birch (Vice-Chairman), Ms. R. Birch, E. Hacker and Mrs. M.R. Wilkinson.

 

 

367     MINUTES – 

 

RECOMMENDED – T H A T the minutes of the meeting held on 13th July, 2015 be approved as a correct record.

 

 

368     DECLARATIONS OF INTEREST –

 

No declarations were received.

 

 

369     PRESENTATION: CHILD AND ADOLESCENT MENTAL HEALTH SERVICES (CAMHS) –

 

The Committee welcomed back Rose Whittle, the Commissioning Lead for the Cardiff and Vale Community and Adolescent Mental Health Service (CAMHS), and she was joined by Dr. Claire Ball, the regional Clinical Director for CAMHS.

 

The Commissioning Lead began the presentation by advising Members that, in October 2013, the University Health Board commenced a work programme to agree a sustainable service model for emotional and mental health services.  This was reported to the Scrutiny Committee back in September 2014.

 

To progress this piece of work the Cardiff and Vale University Health Board had allocated £180,000 in 2015/16 to improve primary mental health services.  In addition the Welsh Government had recently announced £7.65m recurring funding to support children with emotional and mental health difficulties across Wales.

 

In terms of progress since September 2014, Members were advised that an agreement had been reached regarding a primary multi-agency support pathway.  In addition, a specialist CAMHS service specification had been developed and new specialist referral criteria were being finalised.  These were in conjunction with a new pathway which was agreed for neurodevelopment disorders that now included a single point of referral. 

 

In Cardiff and the Vale, its share of the new national funding had been allocated in principle and business cases had been developed which were awaiting approval and which focussed on the following:

 

  • Primary mental health
  • Neurodevelopment pathways
  • Early psychosis and transition
  • Increased psychological approaches in specialist CAMHS
  • Seven day support for crisis intervention.

 

In terms of primary mental health services, the additional £180,000 would support the development and commissioning of an Emotional Wellbeing Service.

 

The Model for the new service was currently under development and this would include the following:

  • Access to rapid assessment
  • Direct access for general practitioners
  • Single point of entry for emotional wellbeing and CAMHS services
  • Intervention support, both as an end in itself and support while waiting for CAMHS
  • Interventions will include activities such as group work, text support, 1 : 1 work, mindfulness training, anger/anxiety management
  • Support for training and consultation
  • Interventions to be provided at a hub, or convenient locations such as schools or youth services.

The service specification for the Model would be completed by the end of September.  Specification would include close working with colleagues in Social Services to close any gaps and to ensure that there was no disconnect.  The specification would soon go out to tender and it was anticipated that a tender would come from a partnership approach led by a Third Sector organisation.

 

In referring to neurodevelopment disorders, the Committee was advised that a ‘single model, single pathway’ had been created that incorporated Community Child Health, Primary Care and CAMHS.  Additional Welsh Government funding had been provided to support a multi-disciplinary approach, with a dedicated co-ordinator and nurse triage.  A single point of contact had been developed and this would include a direct telephone link to allow families to speak directly to nurses

 

In addition, demand and capacity modelling was being undertaken to support the shaping of this model which would facilitate communication and information sharing across traditional boundaries.  As part of the development, there would be an agreement from Education around what assessment would be used within schools.  A minimum data set for referrals would be agreed and this information needed to be provided before a referral was accepted.  This will help to facilitate the assessment and diagnosis of young people and would ensure that specialists could focus on areas that only they could do.

 

Further to the aspect of neurodevelopment disorders, the Clinical Director stated that there was a need to speed up the process.  This was recognised as an important development and she stated that she was pleased that a lot of work around this had begun.   This would assist the prioritisation of resources to CAMHS and she went on to comment that Welsh Government had identified two performance targets which were:

  • All urgent CAMHS assessments to be undertaken within 48 hours, to commence from the end of October 2015 and;
  • All routine specialist CAMHS assessments seen within 28 days, to come into effect from 1st April 2016.

In terms of specific specialist CAMHS referral information for the Vale of Glamorgan, the Committee was advised that, between January and June 2015, 261 referrals were received.  In total, there were 178 people on the waiting list of which 56 individuals had been waiting for a service for a period longer than 26 weeks.  The longest wait for a service was 54 weeks.  Members were also advised that 19% of appointments were cancelled by families and that 12% of appointments had
resulted in families failing to attend.  Members were advised that these figures related to the old service model.

 

The Chairman in referring to the extra funding provided by the Welsh Government queried whether this would be enough in order to carry out the necessary improvements.  In response, the Clinical Director stated that the previous model was too focussed on the medical side of the service and it had been recognised that this was not fit for purpose.  The important aspect of the new funding was around the recruitment of the necessary workforce which would be a challenge as there would be competition when attracting new staff.  There would be a need, therefore, to be creative around how to attract the appropriate staff and this issue had been recognised by the Welsh Government. 

 

A Committee Member queried as to what was the process for children that needed urgent help.  In response, the Committee was advised that this would depend upon treatment.  Urgent cases would be for those identified with an acute need such as psychiatric treatment or severe depression.  Diagnosis by the general practitioner would be followed by rapid access to services for which an appropriate well-being pathway plan would then be devised.

 

In response to the Committee’s query as to whether children and young people were involved in the decision-making process, the Commissioning Lead advised that following the mental health measure children and young people had a critical part in deciding the pathway.  All Care and Treatment Plans would be co-signed by the parents and the child or young person in question.  An important part of this was the involvement of youth forums in devising service strategies which would also include colleagues from the Third Sector.  The Commissioning Lead stated that ‘joining up the dots’ was now a key priority.

 

A Committee Member, in referring to the desire to reduce the waiting time down from 26 weeks to 28 days, queried how this would be achieved.  The Clinical Director stated that an historic issue was that all referrals for neurodevelopment disorders had been referred to the CAMHS service.  An identified issue had been the need for CAMHS staff to look at and consider all referrals, many of which were not appropriate to receive service support.  This had caused a back log which the service was working through.  Partnership planning and joint working would help to reduce this.  Members were further advised that the new targets would be a challenge and that there was likely to be a lag before the service got things right.  In the shorter term a bid for further funding for Welsh Government to recruit staff in a quicker time frame had been made which would be the start of the change process. 

 

Further to this, the Chairman queried as to how many children and young people on the waiting list were appropriate to the service.  Members noted that across the Cardiff and Vale Health Boards there had been an issue with trawling the necessary data but there was somewhere in the region of 86 appropriate referrals on the waiting list with around a further 380 in the system for follow up.  To tackle this backlog it had been recognised that a better process was needed which would free up capacity.  A key aspect here was to co-ordinate the service efforts and to reduce the level of confusion for parents and to improve the time taken to complete an assessment.  In addition, early intervention was crucial to prevent crisis and to reduce the risk of children and young people experiencing emotional and wellbeing disorders.  The service had pledged to work together to improve access to therapists and to improve multi-agency working. 

 

In response to the Chairman’s query around treatment for those outside of CAMHS, Members were advised that this would be a challenge and that the Community Health Council would be able assist.  The quality of service was the key for which the single telephone service would be important from which all necessary advice and information would be provided.

 

In terms of future improvement and development, the Clinical Director stated that an important aim would be the need to improve child psychology services for which National Institute for Health and Clinical Excellence (NICE) guidelines would soon be published which provided ways of improving the quality of services.  The Improving Access to Psychological Therapies (IAPT) model in England had improved the treatment process and national outcomes were being compiled through a set of core data systems which would allow direct comparison around the quality of service across the whole of Wales. 

 

A Committee Member commented that a lot of issues with young people would be picked up through schools and the Member questioned the link between the CAMHS service and school based counselling services.  In response, the Clinical Director stated that the Mental Health Measure emphasised that the relationship between primary mental health services and schools needed to continue.  It was important to ensure that counselling within schools was not a stand-alone service. 

 

The Chairman, in referring to the preventative work undertaken by Social Services, including cases with domestic violence which were likely to affect the mental health and wellbeing of a child, queried whether any more funding would be available to support Social Services initiatives.  In response the Commissioning Lead stated that these were very helpful comments and that it had been recognised that there was a disconnect between the CAMHS services and some of its partner agencies.  Recent partnership events had highlighted this as an issue and greater partnership involvement around the planning of services would be undertaken.  Further to this point, the Director of Social Services stated that from his perspective he would like to see recognition of the scale in respect of the growing number of children requiring mental health support and experiencing emotional distress as the CAMHS service was playing catch up and he would like to see better co-ordination of service development plans with Children’s Services.

 

With reference to the newsletter entitled ‘Together for Children and Young People’ which was attached at Agenda Item No. 4.3, a Member queried the statement that identified that over the past four years there had been over a 100% increase in referrals to CAMHS and Members asked whether an explanation could be provided.  The Clinical Director informed Members that part of the growing demand was as a result of the disappearance, in some areas, of Council run youth services.  This was in addition to the lack of awareness of options by people making referrals.  She stated that referrals to primary and secondary CAMHS services were not always appropriate but often this was the only avenue available.  In relation to this query, a Member questioned as to whether the economic difficulties within the country were having an effect.  In response, Members noted that this was a complex issue and that the increase in demand was not necessarily linked in a direct linear relationship with the economic situation and that there were a number of reasons which accounted for the growing demand. 

 

Having considered the progress in respect of the CAMHS service the Committee

 

RECOMMENDED -

 

(1)       T H A T the Committee thanks the representatives from the CAMHS service for the update report.

 

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

 

(3)       T H A T the update presentation be forwarded to Cabinet for its consideration.

 

Reason for recommendation

 

(1)       To offer the Committee’s thanks and appreciation to the representatives from the CAMHS service.

 

(2&3)  To keep Members informed around developments to an important service area.

 

 

370     REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL TO 31ST JULY 2015 (DSS) –

 

The purpose of the report was to advise the Scrutiny Committee of the position in respect of the revenue and capital expenditure for the period 1st April to 31st July 2015.  In addition, the report also highlighted progress made in delivering the Social Services Budget Programme. 

 

The current forecast for Social Services was a balanced budget.  In addition to increased demand for services, there was pressure on the Directorate to achieve its savings targets for 2015/16 onwards. 

 

A table and graph setting out the variance between the profiled budget and actual expenditure to date and the projected position at year end were attached at Appendix 1 to the report.

 

In terms of Children and Young People Services, it was still anticipated to outturn £300,000 under budget at year end.  The key issue for this service continued to be managing the demand for the Joint Budget for Residential Placements for Looked After Children, but, currently it was forecast to 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.  However, it was noted that it was still early in the financial year and that due to the potential high cost of each placement, the outturn position could fluctuate with a change in the number of Looked After Children.  There were potential underspend elsewhere in Children’s Services of £65,000 in staffing budgets and £135,000 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 £300,000 over budget at year end.  This was due to a projected overspend on Community Care Packages of £300,000 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 guarantee that it would not deteriorate further by year end as this budget was extremely volatile and there was a continued increase in demand for services.  The annual deferred income budget for 2015/16 had been set at £739,000 and as at 31st July 2015 income received to date was £18,000 under-recovered.  As it was early in the financial year, the year end project was to breakeven against this budget.

 

Capital

 

Appendix 2 to the report detailed financial progress on the Capital Programme as at 31st July 2015.  No changes had been requested to the Programme for this month.

 

Appendix 3 to the report provided non-financial information on capital construction schemes.  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 which would be taken to the earliest available Cabinet meeting. 

 

2015/16 Budget Programme

 

The Directorate was currently required to find savings totalling £3.568m by the end of 2019/20 and this target was analysed by year in the following table.

 

 

Year

Savings   Required

£000

Savings   Identified

£000

In   Year Surplus/ (Shortfall)

£000

Cumulative   Surplus/   (Shortfall)

£000

Savings   Brought Forward

 

34

34

34

2015/16

1,465

1,541

76

110

2016/17

1,133

1,209

76

186

2017/18

320

320

0

186

2018/19

320

320

0

186

2019/20

330

330

0

186

TOTAL

3,568

3,754

 

 

 

 

The surplus shown and the savings brought forward figures were as a result of the foster carer recruitment project, which was being developed in addition to the required savings targets.  This surplus could be used to mitigate any increase in savings to be found in future years.

 

Attached at Appendix 4 to the report was an update on each individual area of saving. 

 

With regard to the development of the former Bryneithin site, the Head of Adult Services stated that the site had been sold subject to planning permission.  Members were advised that the land had been earmarked for the use of people over the age of 50 and following a request by the Chairman, the Committee agreed that an update report would be provided at the next meeting. 

 

A Committee Member in referring to Appendix 4 and project reference B9 - The Contract Arrangements for Domiciliary Care - questioned whether there were any intentions for an on-line auction system to be used.  In response, the Director of Social Services stated that no, this had never been discussed. 

 

The Chairman, in referring to the £270,000 savings target for domiciliary care services which was required in 2016/17 queried whether this was achievable particularly with regard to the fact that over 95% of the care sector was provided by independent providers to which costs would be incurred following the national implementation of the Living Wage.  In response, the Head of Finance stated that it had been recognised that this was a challenging target for the service to hit.  However, she stated that the Commissioning Strategy of the service was fairly robust and was considering a number of options.  Furthermore, the service had correctly recognised the problems associated with block contracts.  In addition to this point, the Director of Social Services alluded to the integration of services with health and the possibility of health investing in some social services, particularly those which aided the discharge of patients from hospitals.

 

A Committee Member queried the progress around the establishment of two working groups, which were aimed at taking forward the work which focussed on outcome based commissioning and the understanding of pressures in the domiciliary care sector.  In response, the Head of Finance stated that the first Working Group focussed around outcome based commissioning started last year and it would link in with implementation of the new Social Services and Wellbeing (Wales) Act 2014.  The aim of this Working Group would be to change the working arrangements and relationships within the sector in order to focus the service on becoming more outcome based.  The second group was looking at the costs associated with domiciliary care providers.  Members were advised that both were internal Working Groups and that the Head of Finance felt reasonable progress had been made.

 

In response to a Member’s query regarding the detail contained within project reference A23 regarding Reshaping Services, the Head of Adult Services stated that the savings target was rather broad and that it was still very much early on in the process and that it was important to have a target to focus the work of the service. 

 

The Committee requested further detail about the predicted overspend to the Older People’s Budget.  The Head of Finance agreed that this would be followed up and information sent to Members accordingly.

 

Having considered the report the Committee

 

RECOMMENDED –

 

(1)       T H A T the position with regard to the 2015/16 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)       To ensure that Members are aware of the position with regard to the 2015/16 revenue and capital monitoring relevant to the Committee.

 

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

 

 

371     UPDATE ON HOW THE COUNCIL IS MANAGING INCREASED DEMAND FOR FAMILY SUPPORT SERVICES (DSS) –

 

The Head of Children and Young People Services presented the report, the purpose of which was to update the Committee on how the Council was meeting the challenges of increased demand for family support services.

 

Members were advised that the Commissioning Strategy for Children and Young People Services 2013-2018 set out how the Council and its key partners intended to meet the wellbeing and social care needs of children, young people and their families within the resources available.  The Strategy described the tiered model of services that was in place to guide the way in which resources were allocated and to help with decision-making in individual cases.  The model was outlined in Appendix 1 to the report. 

 

Work to implement the model within Children and Young People Services and in partnership with other Directorates across the Council, the NHS, the third sector and the independent sector had produced significant results.  By ensuring a focus on early intervention and preventative action across all service provision for children, the service had been able to support families to stay together and to reduce the need for children to be looked after.  This had helped the service to manage demand for care and support at lower levels of intensity / intrusiveness.

 

There was recognition that some of the difficulties which children and young people experienced were as a consequence of factors affecting other family members.  On the basis of evidence from programmes such as Flying Start, a consensus had emerged that the best way to support families (particularly those in poverty) was through whole family services which were provided in an integrated way by a range of agencies and professional disciplines which were tailored to the needs of individual families.

 

Most family support services were provided through the use of fixed-term grants from Welsh Government which required robust arrangements for partnership working between agencies.  The Head of Children and Young People Services talked through some of the funding programmes and schemes associated with Children’s Services. 

 

The Families First grant was provided to Local Authorities to improve outcomes for children, young people and families.  Each Local Authority had to develop a Families First Action Plan which set out how they would implement the programme locally and contribute towards nationally set outcomes.  The Vale of Glamorgan programme currently provided funding for the following projects:

  • Families Achieving Change Together (FACT) team
  • Raising awareness of welfare rights
  • Family support programme
  • Disability focus
  • Partnership for young parents (expanded to cover all of the Vale)
  • Putting families first
  • Young people support programme
  • Young carers
  • C-Card scheme.

It was noted that the critical success of the Families First Programme was the “Team Around the Family” approach, which had been used extensively across the UK.  There was good evidence for positive outcomes. 

 

Delivered in disadvantaged areas of Wales, Flying Start was a targeted Early Years Programme for families with children under four years of age.  This programme was universally available to all eligible children and their families in the areas where it operated.  The core elements of the programme were drawn from a range of options that had been shown to influence positive outcomes for children and their families.  These included:

  • Free quality, part-time child care for two to three year olds
  • An enhanced health visiting service
  • Access to parenting programmes
  • Early language development.

The Integrated Family Support Service (IFSS) helped families to stay together by encouraging them to take positive steps to improve their lives.  Referrals were made to the service when there were concerns about the welfare of children, such as:

  • Substance misuse
  • Domestic violence or abuse
  • History of violent or abusive behaviour
  • Mental health issues.

Families who experienced such difficulties may be at risk of having their children placed into care or having their names placed on the Child Protection Register.  IFSS worked with families to help them to make positive changes so that any concerns could be reduced and children could stay safely at home.  It provided targeted support and helped connect children and adult services, focusing on the family as a unit. 

 

The Communities First Programme provided funding to narrow the economic, education / skills and health gaps between the most deprived and more affluent areas.  There were three strategic objectives helping to achieve these outcomes:

  • Prosperous communities
  • Learning communities
  • Healthier communities.

The Youth Engagement and Progression Framework aimed to reduce the number of young people at risk and not in education, employment or training (NEET).  The Framework was based around six component elements that aimed to:

  • Identify young people most at risk of disengagement
  • Provide better brokerage and co-ordination of support
  • Provide stronger tracking and transition of young people through the system
  • Ensure provision met the needs of young people
  • Strengthen employability skills and opportunities for employment
  • Provide greater accountability for better outcomes for young people.

A multi-agency Management Board was responsible for overseeing Flying Start and Families First.  Membership comprised representatives of the Cardiff and Vale University Health Board (UHB), and the Glamorgan Voluntary Services (GVS), Learning and Skills (which also led on the 14-19 initiative) and Children and Young People Services (which also led on the IFSS). 

 

A “Poverty Alignment Group” had been tasked with looking at common features, joint working and closer alignment of project delivery and project outcomes, in line with Welsh Government’s suggested direction of travel.  This had already led to the development of a Parenting Learning Set, which sought to ensure that a consistent level of training and support was made available to professionals and that provision was properly responsive to the needs of parents. 

 

It was critical to the success of the Council’s Strategy that the overall range of services commissioned or delivered by the Council was responsive and flexible enough to meet varying levels of need and demand.  This meant avoiding long waiting lists or insufficient throughput within services.  However, it was nearly always the case that demand for family support exceeded supply; this was becoming even more apparent with growing levels of family poverty and breakdown.  There had been particular difficulties in managing demand for the FACT team. 

 

The report outlined that, to some extent, this was a consequence of the team’s success in providing very good quality family support services.  It had generated a significant rise in the number of direct referrals.  This issue had been noted by Welsh Government and in respect of other services based upon Team around the Family approaches, although they had yet to release guidance or act to address these concerns.  It was possible too that cutbacks in other services and resources had meant less preventative work was being done with families and hence more referrals were being made to FACT. 

 

The report highlighted that the rate of referrals to FACT was rising and this was illustrated through the following table:

 

2013/14

Number   of referrals

Qtr1

80

Qtr2

53

Qtr3

71

Qtr4

85

Full year total

289

 

 

 

2014/15

Number   of referrals

Qtr1

82

Qtr2

82

Qtr3

71

Qtr4

79

Full year total

314

 

 

2015/16

Number   of referrals

Qtr1

82

 

 

The Committee was advised that in response to the high level of referrals, the team had been undertaking visits to all referring partners (including schools and headteachers’ meetings) to raise awareness of what constitutes an appropriate referral.  Alongside changes to the referral form in September 2014, these meetings were helping to improve the standard of referrals and enabled more appropriate allocation of FACT resources. 

 

There was a very real issue also regarding the increased complexity of referrals, requiring the FACT team to work at a higher threshold than Welsh Government guidance had originally intended.  Again, this was experienced nationally across Wales and not particular to the Vale.  A national report was scheduled for September 2015. 

 

The success of FACT was judged by the distance measured tools used by the team (JAFF scores and Outcome Star) which demonstrated whether the service improved the key issues identified at initial assessment.  As families referred demonstrated increasingly complex issues, members of FACT were working with them longer.  There was an inherent challenge for the team in deciding whether to close cases more quickly and not achieve the positive changes or continue the work until the outcomes were achieved.  In summary, where statutory services tended to focus on working with families to reduce risk, FACT were working on lowering risk as well as improving outcomes and emotional wellbeing for the whole family.

 

To ensure that referrers themselves did not stop working with families, the FACT team no longer held a waiting list.  Recognising that there had been a move away from the Tier 2 referrals where FACT should be focusing, the Families First Management Board allocated resources to pilot a new Resource Panel, which started in November 2014.  Where families referred to FACT were assessed as being below the team’s current threshold they would be referred to the Resource Panel.  This operated until March 2015 as a trial to:

  • Identify which partners could / should provide alternative support
  • Challenge partners to ensure that they were supporting children and families in line with their statutory duties
  • Help inform planners where there were genuine gaps in provision for further consideration by the Families First Management Board.

The Resource Panel had met on several occasions.  The intention had been to target a small number of families, looking at what family support was required following an assessment by the designated worker and what could be offered to support the family.  The process had proved cumbersome and unproductive as it became obvious referrers felt this was just another route to FACT, even though it was chaired by an independent officer and it was made very clear at all points that the referring agency should maintain oversight of the family.

 

After three formal meetings it became clear that, as a model, this was unproductive.  Referring agencies stopped referring once they realised this would not lead to another organisation intervening and taking responsibility for supporting the family.

 

During the pilot of the Resource Panel, alternative models of delivery were explored and contributed to the final Resource Panel Evaluation.  This looked at both local and national models of handling high demand for services, especially family support.  The report was presented to the Families First / Flying Start Management Board in March 2015.  The Board decided to end the Resource Panel pilot and to pilot instead a signposting service aimed at Tier 2 demand.  This phone line service would seek to take initial requests for referral to FACT and offer information, support and advice prior to signposting professionals and families to available services or confirming the need for an assessment.  This should reduce the need to refer to FACT.  The “Families First Advice Line” was under development and it would be live from August 2015 until March 2016.  An evaluation of the service and its impact on FACT referrals would be ongoing during this pilot period. 

 

In referring to the Families First Plan, the report outlined that this was delivering 11 effective projects.  Since 2012/13 there had been an increase of 63% in the number of families benefiting from Families First services and an increase of 80% in the number of children and young people. 

 

Families First had worked closely with Communities First and Flying Start to ensure families received seamless and holistic services, not restricted by age and geography.  Across these partnerships, some of the projects funded through Families First have been expanded through the secondment of Communities First staff helping to deliver the same family support models (Transitions and Putting Families First).  Another Families First project, the Family Support Programme, was managed by Flying Start.  The project provided a Flying Start model of delivery to an area that was not yet eligible for Flying Start funding.  As a consequence, the Vale had been able to expand successful projects and increase the number of children, young people and families receiving a service.  This model of working, pioneered in the Vale and joining up the three main poverty-related grant programmes, was now being promoted at a national level.

 

By targeting the projects it funded in order to help children and young people most at risk, Families First made a significant contribution to the developing Youth Engagement and Progression Framework (YEPF).  Much of this work was delivered in conjunction with the Youth Service.  The YEPF was auditing current provision and implementing mechanisms for early identification of those most at risk.  Once identified, a key worker would be assigned and a referral to support systems made, again seeking to reduce the need for more intensive forms of service provision.

 

From April 2014 to March 2015, a total of 737 young people categorised at NEET were positively engaged through Communities First, G2E, the Young Parents Partnership, Llamau, Glamorgan Volunteer Services, ACT and the People Business Wales.

 

The Chairman, referring to the number of grant schemes, enquired whether there was any likelihood that the Welsh Government would combine these into one funding stream.  In response, the Head of Children and Young People Services stated that there were two key questions here, the first one was around how funding was delivered and the second related to the duration of the funding.  Further to this point, the Director of Social Services stated that he would not anticipate, at this time, any changes to the way that funding was provided.  However, from his perspective, it would be more effective if the Council was able to decide how funds were allocated. 

 

A Committee Member queried as to why there was an increase in the complexity of cases being referred to Family Support Services.  In reply, the Head of Children and Young People Services advised Members that the threshold for the Families First service was pitched by the Welsh Government at Tier 2 and that initially it was not fully recognised that some of these cases were likely to be complex.  The key question here was whether Families First was pitched in the right area. 

 

The Committee in querying the rise in the number of referrals to the FACT team was advised that the referral figures represented those cases that were dealt with by the service.  The Directorate would need to plan for at least a 4% increase each year in service demand which on the face of things appeared to be a fairly modest increase.  When this annual increase was put together with a reduction in resources it was evident that the gap would increase significantly over a period of years. 

 

The Chairman, in referring to a recent feedback event with families and children supported by FACT, stated that it had been noted that the referral process had taken a longer time than anticipated, that some schools were unhelpful and that better aftercare could have been provided.  In response to these concerns, the Head of Children and Young People Services stated that in terms of the referral process delays would depend on who or what agency made the referral e.g. whether this was made through a person’s general practitioner or some other organisation.  She stated that the delay to referrals was not at the point of receipt but at the stage when referrals were sent.  In respect of schools, she commented that the service would consider the issues raised and would look at the working relationships between the service and the minority of schools involved and would work hard to ensure that these were effective. 

 

With regard to better after care support she stated that the new phone line service would present opportunity for follow up and to offer information, support and advice. 

 

Members noted that a national report referred to in paragraph 12 regarding the FACT team and the threshold for services was yet to be published, following which guidelines would be revised. 

 

Having considered the report, the Committee

 

RECOMMENDED –

 

(1)       T H A T the approach taken to provide appropriate levels of family support services in order to manage growing demand, especially within the services provided by the Families Achieving Change Together (FACT) Team be noted.

 

(2)       T H A T a further report is received in 12 months’ time.

 

Reason for recommendation

 

To ensure that Members are kept informed about service developments.

 

 

372     UPDATE ON IMPLEMENTATION OF THE SOCIAL SERVICES AND WELL-BEING (WALES) ACT 2014 (DSS) –

 

The Director of Social Services presented the Committee’s fifth monthly update in respect of the Social Services and Well-being (Wales) Act 2014 (the Act) and the approach being taken in regard to implementation.

 

The report outlined that the Act would come into force in April 2016.  The Committee had requested regular updates on progress being made in readiness for implementing the requirements of the Act in the Vale of Glamorgan.  This month’s report updated information considered by the Committee in July 2015 which included:

  • Information on the second tranche of public consultation issued by Welsh Government on new Regulations and Codes of Practice 
  • Plans for an awareness raising event in partnership with Glamorgan Voluntary Services
  • The Social Care and Workforce Development Programme (SCWDP) and arrangements for a regional SCWDP partnership.

The first tranche of regulations and codes of guidance were laid before the National Assembly in July and these have now been approved.  Appendix 1 to the report contained the public consultation responses made by the Director of Social Services to the second tranche, submitted to the Welsh Government on 31st July, 2015.  This covered the following areas:

  • The Code of Practice in relation to Part 10 (Complaints, Representations and Advocacy Services);
  • Regulations and Code of Practice in relation to Part 5 (Charging and Financial Assessment); and
  • Regulations and Code of Practice in relation to Part 6 (Looked After and Accommodated Children).

Additionally, on 30th June, the Minister of Health and Social Services issued a written statement, clarifying Welsh Government intentions about how the Act would affect Children and Young People’s Services.  This was attached at Appendix 2.

 

As reported previously, the Vale of Glamorgan Social Care Development and Workforce Plan (SCDWP) had been submitted to Welsh Government, in order to qualify for the SCDWP grant, a new Cardiff and Vale of Glamorgan Regional Social Care and Workforce Development Partnership had been established. 

 

Members were advised that a workshop had been held with those partners who had expressed an interest in being part of this partnership.  Discussions from this session would help to shape the Partnership Board and ensure that it was fit for purpose.  The first meeting of the Partnership was held on 31st July, 2015.  As well as confirming the terms of reference, governance and membership of the Partnership Board, it set out arrangements for ensuring robust communications were in place and that all partners were kept up to date.  One of the first challenges for the Board would be to complete a regional update which needed to be returned to Welsh Government by 25th September, 2015. 

 

The report outlined that the Care Council for Wales (Care Council) was working with a range of partners to develop a national learning and development plan to support implementation of the Act.  The overall aim of this initiative (funded by Welsh Government) was to ensure that the workforce was supported and informed to deliver Social Services in accordance with Welsh law and and its interface with other relevant statutes and to practice in accord with the principles of the Act.  It had developed and Information and Learning Hub, a One Stop Shop for the wide range of resources that would be produced as part of this initiative.  Over time, the Hub would include training materials in different formats to help the social care professionals implement legislation in their day to day work.

 

In partnership with the Glamorgan Voluntary Service (GVS), officers from the Vale Social Services Management Team delivered a workshop event at the Barry Memorial Hall on 9th July, 2015.  This event was aimed at staff working in the Third and Independent Sectors, as well as other local authority departments and the Local Health Board.  Over 100 people attended the event which was very well received.  It focussed mainly on areas which were perceived to be the most crucial in implementing, at an early stage, the new model of services required by the Act, which included the following:

  • Information, Advice and Assistance (IAA)
  • Planning and promoting preventative services
  • Supporting the development of new national assessments and eligibility tools
  • Workforce development and training needs.

The above list was not intended to underestimate the need for the service to focus too on many other key areas including safeguarding, charging, advocacy, social enterprises, performance management and regional partnership planning/working.  However, given the very limited timeframe available and the scale of change required it was essential that the Directorate concentrated limited resources on those areas which would most change the relationship between individuals and public services and which would also represent the greatest risk to effective implementation.  The Regional Implementation Plan will need to be amended so that it reflected the strategy.

 

Work to monitor progress against the current version of the Regional Implementation Plan was ongoing and an update was provided at Appendix 3. 

 

With regard to Advocacy Services, the Committee noted that Welsh Government planned to invest money to develop advocacy services and had talked about the creation of regional advocacy services.  However, Members were asked to note that regional services would take time to develop and that there would likely be cost implications which had not been fully recognised as yet by Welsh Government.  This could possibly result in local authorities being subject to Judicial Reviews around provision of services which could have significant consequences. 

 

A Member, referring to the Action Plan attached at Appendix 3, queried progress around action 11.3 on page 13.  The Committee was informed that the intent was to have dedicated capacity on a regional basis to bring together training and development in respect of the requirements of the Act to ensure that staff and partners are fully briefed.  An officer with responsibility for this was being recruited which would help to speed up this process.

 

In terms of the ambitions of the Act, the Director of Social Services stated that the timescales of the Act were challenging and that the Act would come into force during a period of austerity, which no one had anticipated would last for a period of at least 10 years. The Director stated that in some areas the Act would help to manage demand but in other areas it would increase demand.  The National Assembly had discussed the Act in detail, so it was hoped that Welsh Government fully recognised some of the difficulties identified. 

 

The Director of Social Services went on to state that Members would recollect a Third Sector partner event regarding the Act which was raised during the Committee’s previous meeting.  At this event a video detailing some of the significant impacts from the Act were shown to participants and it would be useful for all Members of the Council to see this as well.  The Committee therefore considered it useful that a Member briefing session be arranged which would highlight the main areas of the Act i.e. provision of information, planning and promoting preventative services, supporting the development of new national assessment and eligibility tools and workforce development and training needs.  It was agreed that such a briefing session should take place after Christmas and should ideally be held during March 2016.  Members considered that such a briefing session would be useful to Members, particularly as there would likely be concerns raised by service users living within all Wards.

 

Following consideration of the report the Committee

RECOMMENDED -

 

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

 

(2)       T H A T the Committee continues to receive regular updates about implementing the Act.

 

(3)       T H A T the report be referred to Cabinet, and Cabinet consider the request from the Scrutiny Committee that a briefing session for all Members around the implementation of the Act be arranged to take place some time during March 2016.

 

Reasons for recommendations

 

(1&2)  To ensure that Elected Members are kept informed about fundamental changes in the policy and legislative framework which underpins the work of Social Services.

 

(3)       To ensure that all Elected Members of the Council are fully aware of the potential impact of the Act and that Members are in a better position to respond to possible queries from service users within their Wards.

 

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