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SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)

 

Minutes of a meeting held on 30th November, 2015.

 

Present:  Councillor R.L. Traherne (Chairman); Councillors Ms. R. Birch, E. Hacker, H.C. Hamilton, Dr. I.J. Johnson, J.W. Thomas, S.T. Wiliam and Mrs. M.R. Wilkinson.

 

Also present: Councillor S.C. Egan (Cabinet Member for Adult Services) and Councillor N. Moore

 

 

609     APOLOGIES FOR ABSENCE – 

 

These were received from Councillor Mrs. M.E.J. Birch (Vice-Chairman) and Councillor R.J. Bertin

 

 

610     MINUTES – 

 

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

 

 

611     DECLARATIONS OF INTEREST –

 

No declarations were received.

 

 

612     REPORT ON THE CHIEF INSPECTOR’S ANNUAL PERFORMANCE EVALUATION OF THE VALE OF GLAMORGAN’S SOCIAL SERVICES DEPARTMENT 2014-2015 (DSS) –

 

The Care and Social Services Inspectorate Wales (CSSIW) had reviewed and analysed evidence from the 2014/15 performance year, and the Committee received the overall evaluation of the Vale of Glamorgan Social Services along with evidence of areas of progress and areas for improvement.

 

The Regional Director began the presentation by advising Members that this was the culmination of a year’s work which had included the reviewing of performance indicators along with consideration of reports by the Director and Heads of Services.  The evaluation had also included a number of short site visits and also the use of other regulatory inspection reports.

 

In terms of Adult Services, the Area Manager advised Members that the CSSIW had noted the Council’s work around the key national priority for preventative and early intervention services.  A number of aspects had been highlighted through the evaluation and these included the role of the Customer Contact Centre and the prioritisation to support independence and reablement where possible.  The CSSIW had recognised the reduction in the time to deliver a Disabled Facilities Grant, which had reduced from 214 days to 198 days.  The CSSIW had also noted that the Council’s first Extra Care Scheme had been created through the Golau Caredig facility in Barry, which had a 100% occupancy rate.

 

In meeting the other key national priority, which was around the integration of services for older people with complex needs, the CSSIW had determined that the Council remained a strong leader on a number of integration and partnership initiatives.  In addition, it was noted that the integrated discharge policy had now been implemented. 

 

The CSSIW’s evaluation had also outlined three areas of improvement.  These included the requirement to improve the rate of care plan reviews and to increase the promotion of direct payments for service users of the Community Mental Health Team.  The Service would also need to find a solution with the Cardiff and Vale University Health Board around the conclusion of a single point of contact for the Community Mental Health Team. 

 

For Children’s Services, the CSSIW again had considered how the Council was meeting the key national priority around prevention and early intervention.  It had noted that the expansion phase for Flying Start had been completed along with the work of the Families Achieving Change Together Team and the Integrated Family Support Team.

 

In relation to the national priorities around Looked After Children, the CSSIW had found that a number of children looked after in the Vale had remained relatively stable and that the Council’s strategy to improve permanence arrangements was good.  The CSSIW had identified that the Council was committed to recruiting additional foster carers in order to reduce its reliance on independent foster placements.  This had involved investment in the recruitment of additional foster carers with nine new foster carers approved during the year, which exceeded the Council’s recruitment target of six. 

 

The Council had also continued to lead on the Regional Adoption Collaborative, which was made up of four Councils including the Vale of Glamorgan Council, the City of Cardiff Council, Merthyr Tydfil County Borough Council and Rhondda Cynon Taf County Borough Council.  Within the Vale of Glamorgan, eleven children had been adopted and a further eight placed for adoption during 2014-15.

 

Identified areas of progress from the previous inspection included the continuation with the strategy for ensuring the best outcomes for Looked After Children, particularly in terms of permanency planning.  One other area of progress included the percentage of Looked After Children with Personal Education Plans.

 

Members were advised of areas for improvement within Children’s Services.  These included the need to improve the rate of statutory health assessments for Looked After Children and to work with the Cardiff and Vale University Health Board around ways in which therapeutic needs for Looked After Children and care leavers could be met effectively and efficiently across health and social care. 

 

With regard to leadership and governance within social services, the CSSIW had considered the unified Directorate service plan.  This had set out how Social Services would deliver its part in achieving the Council’s key outcomes and objectives, which were linked to the Corporate Plan 2013-17.  The CSSIW had been able to attend three Scrutiny meetings and found that Scrutiny Members understood the complexities of issues put before them and provided an appropriate level of challenge.  The CSSIW had noted that the Service achieved a balanced budget and, overall, the review found that quality assurance and performance management systems were in place and were adhered to.  An area of improvement around leadership and governance was the need to progress the joint commissioning strategy for Mental Health Services.

 

Members were also advised that the CSSIW were undertaking a number of national inspections and reviews.  These included a review of domiciliary care, services for people with learning difficulties and the care planning for Looked After Children. 

 

The Committee was then given the opportunity to comment on the inspection and evaluation review and the following points were raised.

 

The Chairman began by referring to the need to find a solution with the Cardiff and Vale University Health Board around the single point of contact for mental health clients.  He commented that this was mainly the responsibility of the Health Board and he questioned whether the Welsh Government Minister and the Local Health Board were aware of the issues around this.  In reply, the Regional Director stated that CSSIW evaluation reports would be shared with the Minister and also Health, and that this allowed for the creation of a platform in which issues could be highlighted. 

 

In response to the Chairman’s query regarding the need to improve Mental Health services for children and adolescents, the Regional Director stated that this had originally been highlighted by the CSSIW following a thematic review of the contribution made by the Child and Adolescent Mental Health Service to meet the needs of children and young people who were exhibiting risky behaviour across Wales.  Since then, it had been identified that the situation had moved on and that a better service was being developed.  Further to this, the Chairman also raised the issue of staff recruitment within the area of children’s mental health services and was advised that the Welsh Government Minister would be aware of this.

 

The Committee also discussed the role of Health within this area and it was commented that this made a good case for closer integration and partnership working.  To this, the Regional Director stated that across Wales all Local Authorities had good examples of integration and, in terms of the Vale; there were good foundations in place.

 

A Committee Member queried reasons why the percentage of clients with a care plan that should have been reviewed had decreased for a second year.  In response, the Head of Adult Services stated that the number of reviews to be carried out was dependent upon the population of older people using social care services, which had grown.  He explained, that the Service had prioritised ‘first responder assessments’ which had increased and this was where the Service had focused its energies.  He further advised that the need to review care packages would be improved by reconfiguring social care work teams.

 

The Chairman asked if the officers from the CSSIW could comment on how well Local Authorities in Wales were prepared for the Social Services and Well-being (Wales) Act 2014.  The Regional Director stated that although Local Authorities were doing a good job to prepare for the Act, some were at different stages to others.  She explained that there was evidence across Wales that not everything within the Act would be in place by 1st April, 2016.

 

As a final point on the CSSIW’s evaluation, the Director of Social Services provided some of his thoughts.  He stated that the Service valued the scrutiny from the CSSIW and the review by peers; and the relationship that existed was based on mutual respect.  He outlined that the evaluation was an excellent reflection on the staff and the services, which also recognised the challenges that the Service faced.  He was pleased that the CISSIW had validated the contents of the Director’s Annual Report and he stated that all areas of improvement identified in the evaluation would be taken very seriously.  In terms of collaboration, he commented that it had been recognised that good relations existed with the City of Cardiff Council and the Local Health Board and that going forward they would build on these further.

 

Having considered the report, the Scrutiny Committee

 

RECOMMENDED –

 

(1)       T H A T the key messages to emerge from the evaluation be noted.

 

(2)       T H A T Cabinet be advised of the outcomes of the Care and Social Services Inspectorate Wales’ Annual Performance Evaluation and the areas of progress and improvement.

 

Reason for recommendations

 

(1&2)  To ensure that Members are kept informed about outcomes from independent evaluation of social services performance in the Vale of Glamorgan.

 

 

613     INITIAL REVENUE BUDGET PROPOSALS 2016/17 (DSS) –

 

The initial budget proposals for 2016/17 were submitted to the Committee for consideration together with the Amended Budget for 2015/16 for services which form part of the Committee’s remit. 

 

In commencing this item, the Chairman asked if the Director of Social Services could provide Members with some context behind the budget settlement.

 

The Director of Social Services began by advising Members that it was important to outline some context as the Service was showing a potential overspend.  He stated that Social Services now had an established record for achieving a balanced budget, but this was becoming more difficult in terms of the changing demographics and cost pressures.  He explained that this was a national picture which also included complex issues such as the need for greater integration with health.  He went on to refer to the reliance on grant funding from Welsh Government which had been reduced and the need to find savings on an annual basis.  There were also increasing expectations and he cited the example of changes to advocacy services for children, which would increase costs across Wales by an additional £800,000 per year.  He also alluded to legislative and case law changes, such as changes to the Deprivation of Liberty Safeguards which had a very adverse impact and he also made mention of future pressures which may come about following the new Regulation and Inspection Act which would require a system of regulation for care sector staff. 

 

He went to comment around the cost pressures highlighted in Appendix 3 to the report and the way that the Service was attempting to manage costs demands through schemes such as the Learning Disability Commissioning Strategy.  He also mentioned how well the Service had managed the level of fees paid for residential and domiciliary care and how the Service had made a number of savings by reducing the number of managers, which had been undertaken across all divisions.  The Service had looked at all areas of savings and the Council prided itself on its ability to maintain frontline services.

 

The Director advised Members that it was important to remember the growth of care packages and the cap on the charge for non-residential care services, which affected the Vale more than other local authorities.  He went on to refer to the performance of the Service, which was ‘holding up’ and the positive comments made earlier in the meeting by the Care and Social Services Inspectorate for Wales.  Members were also asked to note the pressures that staff were under and the increase of caseloads; the Service could therefore not allow standards to fall in statutory services below an acceptable level.

 

As a final point and in terms of the potential overspend, the Director stated that the Head of Adult Services did have a recovery plan in place, which it was hoped would impact on service pressures and also help to achieve savings.

 

In referring back to the report, this highlighted that the Council’s budget was determined largely by the Revenue Support Grant (RSG) settlement set by the Welsh Government (WG).  In previous years, the provisional RSG settlement was received from WG during October, with the final settlement being received during December.  This year, however, the initial budget proposals had not yet been received.

 

A statement on the timing of the WG’s budget for 2016/17 was released by the Minister for Finance and Government Business on 6th October, 2015.  This stated that the late timing of the UK Government’s Spending Review presented WG with significant challenges for the preparation and publication of the Draft Budget.  It was highlighted that WG had not known their Budget for 2016/17 until 25th November, 2015.  WG was facing unprecedented levels of uncertainty and consequently would not publish the Draft Budget for 2016/17 until 8th December, 2015 with the Final Budget being released on 1st March, 2016.

 

WG’s timetable showed the Local Authorities would be advised of the Provisional Settlement on 9th December and of the Final Settlement by 9th March, 2016, however, the Final Budget would be debated by WG on 9th March, 2016.

 

In addition, the report highlighted that the Council was required under statute to fix the level of Council Tax for 2016/17 by 11th March, 2016 and in order to do so, would have to agree a balanced revenue budget by the same date. 

 

Revised Budget 2015/16

 

Appendix 1 to the report set out the Amended Budget for 2015/16, together with the necessary adjustments to be made to the original budget.

 

The following table compares the amended budget with the projected outturn for 2015/16:

 

 

       2015/16

2015/16

Variance

 

Amended

Projected

 (+)Favourable

Directorate/Service

Budget

Outturn

 (-)   Adverse

 

            £’000

£’000

       £’000

 

 

 

                          

Social Services

 

 

 

Children   and Young People

14,540

14,090

                    +450

Adult   Services

37,579

38,329

                     -750

Business   Management and Innovation

304

304

                           0

 

 

 

 

Total

52,423

52,723

 

-300

The report advised that the projected outturn for the Social Services Directorate was an adverse variance of £300,000 when compared to the amended budget.

 

In terms of Children and Young People’s Services, the report stated that this service was anticipated to outturn £450,000 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, however, currently it was forecast to outturn with a £250,000 underspend at year end.  There were also potential underspends elsewhere in Children’s Services of £65,000 on staffing budgets and £135,000 on alternative means of provision and accommodation costs required for the current cohort of children.

 

With regard to Adult Services, it was advised that this service was currently anticipated to outturn £750,000 over budget at year end.  This was due to a projected overspend on Community Care Packages of £950,000 as a result of increased demand for services, particularly for frail older clients.  The annual deferred income budget 2015/16 had been set at £739,000 and as at 30th September, 2015 income received to date was £74,000 under-recovered.  It was currently being projected that this budget would outturn at £50,000 over budget by year end and this adverse variance was included as part of the projected overspend for care packages.  It was anticipated that there would be underspends of £200,000 elsewhere in the budget which could offset part of this overspend with £165,000 from staffing, £20,000 from Transport and £15,000 from premises.

 

Savings 2015/16

 

Attached at Appendix 2 to the report was a statement showing the progress made to date against the 2015/16 savings targets.  It was currently considered that all savings would be achieved.  Care package savings had been allocated to Learning Disabilities and Mental Health Services.  Savings in these areas had been made, however, demand for services for frail older clients had created additional pressures and were resulting in an overspend against this budget.

 

Budget Strategy

 

The Budget Strategy for 2016/17 outlined that in order to establish a baseline, services should prepare initial revenue budgets based on the cost of providing the current level of service and approved policy decisions and including the existing savings targets. 

 

Medium Term Financial Plan

 

The Medium Term Financial Plan 2015/16 to 2018/19 was to be presented to Cabinet on 14th December, 2015, to coincide with the presentation of the Draft Corporate Plan.

 

The 2015/16 Final Revenue Budget Proposals would set savings targets to be achieved between 2016/17 and 2017/18 of £17.822m for the Authority as a whole, excluding schools.  This was based on the anticipated reduction in funding from WG of 4% in 2016/17 and a further 2% in 2017/18.

 

The latest Plan factored in a managed level of cost pressures, a notional increase in Council Tax of 2% each year, price inflation of 1% and annual pay awards of 1% each year from 2016/17.

 

Provisional Settlement 2016/17

 

The provisional settlement from WG would not be published until 9th December, 2015.  However, the Council was unable to wait until this date to commence its budget preparations for 2016/17 and therefore the report had been based on the projections previously used as part of the Medium Term Financial Plan for 2014/15 to 2017/18. 

 

Based on the projection of a 4% reduction in funding from WG in real terms, the Council was projected to receive £111.537m from WG as RSG and a share on the Non-Domestic Rates of £34.845m.  Together these figures constituted the Council’s projected Aggregate External Finance of £146.382m. 

 

2016/17 Initial Budget Proposals

 

The report stated that as part of the initial proposals, it had been necessary to revisit the cost pressures facing services in order to build up a complete and up to date picture of the financial position for which an updated list for this Committee was shown at Appendix 3.  These included a new cost pressure for the introduction of the National Living Wage from 1st April, 2016, which would provide for a minimum hourly rate of £7.20 for workers aged 25 and above.  It was noted that this change had a significant effect on services commissioned by the Directorate from external organisations. 

 

Details of the proposed areas for savings for 2016/17 through to 2017/18 for this Committee was attached at Appendix 4.  A summary of the overall base budget for 2016/17 was attached at Appendix 5.  This had been arrived at by adjusting the 2015/16 budget for items such as inflation and unavoidable growth, but did not include identified cost pressures or savings.  These were shown as a note to the table and were further detailed in Appendices 3 and 4. 

 

If all identified cost pressures were funded, this would increase the shortfall to £18.601m.  If all proposed savings were achieved, the shortfall would be reduced to £6.431m.  The shortfall was already based on the requirement to achieve a high level of savings in 2016/17 and also included the increase in Employers national Insurance which would take place from April 2016. 

 

Further work would be undertaken by the Budget Working Group in order to achieve a balanced budget for the final budget proposals for 2016/17.  This would include a review of the use of reserves, a possible increase in Council Tax, a review of all cost pressures, possible changes to the approved saving targets, a review of the inflation assumptions and the current financial strategies.  The Budget Working Group would also consider the results of the budget engagement process in determining priorities for future savings and service delivery and the impact of the revised Corporate Plan.

 

The Chairman requested if Officers could provide explanations as to how each of the cost pressures, shown in Appendix 3, were determined.

 

S1 – Managing demand at Initial Point of Access

 

In referring to this cost pressure, the Head of Children and Young People Services advised Members that this was linked to the introduction of the Social Services and Wellbeing Act and to challenges around increased demand.  This was also linked to the work around early intervention and preventative work and the need for additional resources for the new Multi-Agency Safeguarding Hub.  The additional £120,000 would be for staff at the front end of the service.

 

The Committee agreed that, as a cost pressure, this should be funded.

 

S2 – Increasing Numbers of Looked After Children and Children Supported to Live with their Families as an Alternative to Care and Accommodation Costs for 16 year Olds and Over

 

For this cost pressure, the Head of Children and Young People Services explained that the £555,000 was linked to the Children’s Commissioning Strategy and the need to reduce the number of Looked After Children by offering alternatives to care such as greater family support services and more respite.  It was also linked to challenges in managing more complex cases and supporting children through therapeutic fostering arrangements.  There were also elements directly attributable to the new Act.

 

The Chairman went on to query how much of this cost pressure could be attributed to the new Act.  In reply, the Head of Children and Young People Services stated that Welsh Government’s ‘When I am Ready’ initiative was directly linked to the Act.  She also advised Committee of the position of Welsh Government that the Looked After Children population in Wales was too large and needed to be reduced.

 

The Head of Children and Young People Services was able to breakdown the total cost pressure and advised Members that £180,000 could be attributed to the ‘When I’m Ready’ initiative.

 

In reply to a follow up question regarding whether the cost pressures were funded in an appropriate way, the Director of Social Services commented that this related back to the Commissioning Strategy.  He drew Members attention to the trends experienced over the past 5 years, when the number of Looked After Children had increased month by month, with considerable cost implications.  The Service had been able to reverse this trend despite an increase in demand.  He stated that the aim was to respond better to children on the ‘edge of care’ by helping families to stay together.  He made reference to issues around the demand for the Families First service that had been identified at a previous Committee meeting.  As a final point he mentioned that the Service would have to find other ways of working as otherwise Looked After Children numbers could increase.

 

The Committee was in agreement that this cost pressure should be fully funded.

 

S3 – Legal and Advocacy Costs

 

In considering this cost pressure, the Committee heard that the Council had a central reserve for legal costs which was not for the same purpose as that identified for this cost pressure.  Members were advised that legal costs for the Service related to complex Court proceedings for Looked After Children, the numbers of which may have increased.

 

The Committee was also advised that two thirds of this cost pressure was attributed to legal costs with the remainder associated with advocacy services.

 

The Committee was in agreement that this cost pressure should be fully funded.

 

S4 – Children with Complex Medical Conditions Living Longer

 

The Committee was advised that this was connected to domiciliary care costs which were mainly as a result of the increase in the national minimum wage.  The Service had also projected that the number of children with complex needs living longer would increase.

 

The Committee was in agreement that this cost pressure should be fully funded.

 

S5 – Impact of Continuing Demographic Growth in Numbers of Very Old people in the Population

 

Members noted that this cost pressure was based on a report completed back in August, which highlighted a rise in the number of people aged 85 or over.  The Head of Adult Services explained that between 2011 and 2015, the population of people aged 85 and over increased by 18% and this was predicted to rise by 91% between 2013 and 2030.

 

The Director of Social Services also advised that up until 2009, the Council average budget rise per year was 5.5% and that such increases had now stopped.

 

The Committee agreed that this cost pressure needed to be funded.

 

S6 – Changes in legislation and policy including Social Services Wellbeing (Wales) Act 2014 and Sleep Ins

 

In terms of ‘sleep ins’, the Head of Adult Services advised the Committee that this had come about following a change in employment law.  ‘Sleep ins’ mainly related to supported accommodation settings, where staff would be asleep on the premises and would be expected to wake should a care need arise.  It had now been deemed unlawful if this meant that the overall salary for an individual fell short of the national minimum wage.  Members noted that of the total cost pressure of £275,000, £135,000 of this related to ‘sleep ins’ and £145,000 could be attributed to the Social Services and Wellbeing Act.

 

The Chairman questioned whether this cost pressure was sufficient in view of the potential cost of implementing the Act.   In reply, the Committee was advised that there were costs associated with the Information, Advice and Assistance part of the Act but changes to Care and Support had been difficult to cost as only some of the required detail and information had been received.

 

A Committee Member enquired as to whether these were on-going cost pressures.  In answer to this, the Head of Adult Services stated that it could be argued that some of these were one off costs, but some such as the setting up of a Social Enterprise could not be described as a one off.  He also stated that services around the Information, Advice and Assistance part of the Act could be relatively small, although this would not be fully known until services were up and running.

 

At this point the Cabinet Member, with permission to speak, stated that the ageing population did have an effect on the budget but as an Authority, the Council should be celebrating that people were living longer and more independently.  With regard to cost pressures, he stated that there were the ‘knowns’ and the ‘unknowns’ and in respect of the Act, Welsh Government had indicated that this would be cost neutral.  However, he stated that there was evidence to show that implementation would cost the Council money.  As a final point, he alluded to the impact that legislative and legal changes could have on the Council’s budget and he raised the issues around Deprivation of Liberty Safeguards as an example.

 

Members agreed that this cost pressure should be fully funded.

 

S7 – Grant Cessation / Change in Arrangements – Intermediate Care Fund (ICF), Regional Collaborative Fund (RCF), Supporting People

 

With consideration of this cost pressure, the Chairman queried the position of the local health board and the funding of joint projects and services.  In response, the Head of Adult Services explained that health had agreed funding for a number of projects and that without this money the cost pressure would be higher.  He also stated that without health funding, closer integration with health would still continue.

 

A Committee Member commented on the Council’s grant exit strategies and he queried that as ICF and RCF were set up by Welsh Government as ‘invest to save ‘projects, were they producing any savings.  The Head of Adult Services stated that savings had been made. The Reablement Service had improved the capacity of the Service to return people to full independence and had been very positive.  The reviewing of high cost learning disability cases was also positive, assisting people to live more independently.

 

With regard to the changes to the Supporting People Grant, Members noted that Welsh Government had reduced the funding to the Council.

 

The Committee was in agreement that this cost pressure should be fully funded.

 

S8 – Increasing hospital discharge activity

 

The Committee heard that this was linked to the reduction in the number of people who experience a Delayed Transfer of Care, for which two extra social workers had been allocated as part of the Hospital Discharge Team.  Members also noted that people who stayed in hospital too long could eventually have a higher degree of care needs.

 

The Committee agreed that this cost pressure needed to be funded.

 

S9 – Transitions From Children’s to Adult Services

 

For this cost pressure, Members were advised that the Service was tracking a number of individuals that would require extensive care and support.

 

The Committee was in agreement that this cost pressure should be fully funded.

 

S10 – Change in UK policy – National Enhanced Minimum Wage

 

In considering this cost pressure, the Chairman queried whether carer travel time had been included as part of the overall calculation.  In response, the Committee was advised that the overall figure of £1.35million did not include travel time.  Work around travel time cost implications was still ongoing for which regular workshops with care providers were taking place.

 

The Director of Social Services went on to comment that anticipating costs in this area was challenging which included consideration of pension liabilities and the outcome of a judicial review.  He stated that this was developing on a week by week basis and that the amount highlighted as a pressure was a minimum.  He advised that more work around this was needed.

 

At this point, Mr. Brian West, a representative from the independent care sector who had requested to address the Committee prior to the meeting, was invited to advise Members about some of his thoughts on this issue.  Mr. West stated that following a quick look at costs for the independent sector, it had been projected that for the domiciliary care sector, an extra £861,000 had been identified along with an extra £700,000 for the residential sector.  This made a total of £1.561million.  He also raised other potential costs following changes to holiday pay and zero hours contracts.

 

Following Mr. West’s comments, the Director of Social Services stated that providers should be involved when assessing the impact and the Service had recognised the pressures on the level of fees paid to care providers in the Vale.  He advised that more work in regard to reconciling the figures still needed to be undertaken.

 

Overall, the Committee was in agreement that this cost pressure should be funded. However it was important as a matter of some priority that the Council effected further work on the impact of the National Living Wage and the additional costs of travel time that care providers would now have to fund.  It was confirmed that officers were engaging with ongoing work across the South East Wales Improvement Collaborative Region.

 

Following further discussion on the cost pressures, the Committee also considered it important that Cabinet make written representations to Welsh Government on three separate issues that involved new cost pressures which were outside the control of the Council.

 

Firstly, it was abundantly clear that the Social Services and Well Being Act was not cost neutral and that its implementation was going to cost the Council a great deal of money.  As this was a result of Welsh Government legislation then it would seem only equitable that these additional costs should be borne by Welsh Government and not by the Council. 

 

Secondly, the introduction of the National Living Wage would result in substantial additional costs to providers of residential and domiciliary care.  These costs would need to be passed onto the Council.  The situation was exacerbated by the fact that providers of domiciliary care now had to pay their staff travel time and the additional costs involved to providers would also need to be passed onto the Council.  It was invidious for the Council to have to fund these additional costs.  This was particularly so of the National Living Wage which was the direct result of UK Government legislation.

 

Thirdly, the cessation of grant funding for the RCF and the transfer of the ICF to the health board had meant that the Council now had to fund much of the continuing integration agenda.  Not to do so would seriously compromise all the excellent work that had been affected to date.  The reduction in the Supporting People Programme Grant would also mean that the Council would need to step in and fund part of this programme.  It was particularly inequitable that the Council should have to now fund integration which should be led and funded by Welsh Government.

 

After considering the report the Committee

 

RECOMMENDED –

 

(1)       T H A T the amended revenue budget for 2015/16 be noted.

 

(2)       T H A T the Scrutiny Committee (Corporate Resources) agree the Committee’s request that all the cost pressures as detailed in Appendix 3 of the report are fully funded.

 

(3)       T H A T the Scrutiny Committee (Corporate Resources) notes that the cost pressures as detailed in Appendix 3 of the report could increase in view of the requirement  to carry out further work on the  impact of the National Living Wage and the new costs associated with the payment of ‘travel time’ by independent care providers. In addition it was clear that there may be other additional costs, above those already identified in the cost pressures, as a result of the introduction of the Social Services and Well Being Act.

 

(4)       T H A T the Cabinet be requested to make three separate written representations to Welsh Government on the following:

 

i.          The additional costs incurred by the Council as a result of the UK Government’s introduction of the National Living Wage and the requirement for domiciliary care providers to pay travel time.

ii.         The fact that the Social Services and Well Being Act was not cost neutral and that the Council has incurred substantial additional costs as a result of the introduction of this Welsh Government legislation.

iii.        The fact that the Council now has to fund much of the integration agenda in view of the cessation of RCF and the transfer of the ICF to health boards, and that the Council is also having to fund elements of the Supporting People Programme.

 

Reasons for recommendations

 

(1)       To advise the Committee of amendments to the 2015/16 budget.

 

(2)       To advise Scrutiny Committee (Corporate Resources) of the Committee’s views that the cost pressures shown in Appendix 3 should be fully funded.

 

(3)       To ensure that the cost pressures are accurate.

 

(4)       To advise Welsh Government of the substantial additional costs that the Council has incurred, that are completely outside the Council’s control, which as such should be funded by Welsh Government.

 

 

614     INITIAL CAPITAL PROGRAMME PROPOSALS 2016/17 (DSS) –

 

The Committee was informed of the current progress on the Capital Programme for 2015/16 and was requested to consider the initial capital proposals for 2016/17.

 

Appendix A to the report detailed financial progress on the Capital programme as at 30th September, 2015.  The report highlighted that for the Cartref Porthceri Lift Replacement, £70,000 had been allocated for this scheme to commence in 2015/16.  A survey had confirmed that the list needed to be refurbished and not replaced.  It had therefore been requested that this scheme be renamed “Social Services Lift Refurbishments” and works would be extended to include refurbishment works to lifts in Southway and Ty Dyfan. 

 

The report informed that the Council’s Capital budget was determined largely by the General Capital Funding Settlement from the Welsh Government (WG).  In previous years, the provisional settlement had been received in October, with the final settlement being received during December.  However, for this year the initial budget proposals had not yet been received. 

 

A statement on the timing of the WG’s budget for 2016/17 had been released by the Minister for Finance and Government Business on 6th October, 2015.  This stated that the late timing of the UK Government’s Spending Review had presented WG with significant challenges around the preparation and publication of the Draft Budget.  WG had therefore not known their Budget for 2016/17 until 25th November, 2015.  WG was therefore facing unprecedented levels of uncertainty and consequently would not publish the Draft Budget for 2016/17 until 8th December, 2015 and the Final Budget on 1st March, 2016.

 

A timetable published by WG showed that Local Authorities would be advised of the provisional settlement on 9th December, 2015 and of the Final Settlement on 2nd March, 2016, however, the Final Budget would be debated by WG on 9th March, 2016. 

 

In order to be in a position to meet the statutory deadlines and the requirements for consultation set out in the Council’s Constitution, much of the work on quantifying the resource requirements for the Capital Programme would still need to be carried out before the initial and final General Capital Funding Settlement was notified to the Council.  Therefore, in line with the approach adopted in the current Medium Term Financial Plan, the proposals assumed a reduction of 10% for each year of the programme from 2016/17 onwards.  This had been reflected in the proposed Capital Programme for 2016/17 to 2020/21, which was shown in Appendix B.

 

New capital bids had been invited for return by 30th September, 2015, 3 had been received from Learning and Skills, 12 from Social Services, 11 from Environment and Housing and 2 from Managing Director and Resources.  Departments had been requested to rank their own bids in order of importance before submission and bids from each Department were forwarded to the Corporate Asset Management Group (CAMG) for evaluation.  The CAMG had used a criteria set out in the Budget Strategy so that bids could be prioritised in terms of their corporate priority and the risk they posed to the Council if they were not pursued. 

 

It was noted that only those schemes assessed as corporate priority 1 or higher and medium risk or higher were include in these proposals.  The bids that did not meet these criteria or were excluded from consideration because funding had already been allocated as part of the current Capital Programme were set out in Appendix C to the report with a reason for their exclusion. 

 

The report highlighted that the condition of Social Services buildings was deteriorating.  To enable the maintenance of these properties, it had been proposed that £100,000 be vired each year from 2016/17 to 2020/21 from the All Services Asset Renewal budget to create a Social Services Asset Renewal budget.  Social Services would be able to allocate the funding within year to priority works that were required.  This change had been reflected in Appendix B.

 

Members were also advised that the Service would have to prioritise those projects within the new Social Services Asset Renewal budget.

 

Having considered the report, the Scrutiny Committee

 

RECOMMENDED –

 

T H A T the changes to the 2015/16 Capital Programme be noted.

 

Reasons for recommendations

 

To ensure that Members are aware of the position with regard to the 2015/16 Capital Programme relevant to this Scrutiny Committee.

 

 

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

 

The Scrutiny Committee had requested monthly updates in respect of the Social Services and Well-being (Wales) Act 2014 (the Act) and the approach being taken around implementation.

 

The Act would come into force in April 2016 and the report updated information considered by the Committee in September 2015, which included:

 

  • A draft legislative timetable setting out the proposed timescales for laying the remaining regulations and Codes of Practice before the National Assembly, for approval;
  • An update on the workforce development proposals being managed through the Care Council for Wales;
  • The Cardiff and Vale of Glamorgan Regional Social Care Workforce Development Partnership Mid-Year Monitoring Report and updated Plan, submitted to Welsh Government on 25th September, 2015;
  • An update on the statutory Code of Practice in relation to measuring social services performance.

 

An updated Cardiff and Vale of Glamorgan Regional Implementation Plan was attached at Appendix 1.  This was submitted to Welsh Government on 16th October 2015.  The plan reflected the nine work streams being delivered through the Implementation Programme and it included a risk assessment. The governance structure for this programme was appended to the plan and regional task and finish groups for each work stream had been established.  These were led by Heads of Service and Directors from both local authorities, with the remit to develop local action plans.

The report advised that on 3rd November, 2015 the Minister for Health and Social Services issued a detailed written statement updating on legislative, national and regional implementation of the Act.

 

This advised that the revised tranche 2 regulations and final Codes of Practice for Parts 2 (General Functions), 3 (Assessing the Needs of Individuals), 4 (Meeting Needs), 5 (Charging and Financial Assessment), 6 (Looked After and Accommodated Children), 10 (Complaints, Representations and Advocacy) and 11 (Miscellaneous and General) of the Act had now been laid before the Assembly for scrutiny.  It was also noted that the Minister would also publish statutory guidance on Parts 7 (Safeguarding) and 9 (Co-operation and Partnership) during November 2015.  These, together with the Code of Practice in relation to measuring social services performance would substantially complete the legislative
framework under the Act and provide much of the detail required for implementation.  The final Code of Practice, in relation to Part 8 of the Act (the Role of Directors of Social Services) was currently out to consultation which would close on 4th December and would be laid before the Assembly in February 2016. 

 

The report highlighted that the Association of Directors of Social Services and the Welsh Local Government Association had agreed to co-ordinate the work of the six regional implementation collaboratives.  Three of the four national work groups established to share best practice and produce consistent material on an all-Wales basis had met.  Cardiff and the Vale region had appointed officers to each of these groups so that the Service could contribute to the development of national toolkits and, where possible, avoid duplication. 

 

There was growing concern about urgent progress needed in making available as soon as possible a set of detailed technical briefings from WG summarising the duties placed on Local Authorities and their statutory partners by the Act.  Two major information events for stakeholders were held during November, one in North and one in South Wales.  The Service was looking especially for urgent development of the national assessment and eligibility toolkit but this was proving difficult to get consensus.

 

One of the key tasks was to communicate to the general public the changes the Act would make.  To this end, a WG-led national awareness raising campaign would commence in January 2016, preceded by an easily accessible summary publication developed for a wide range of audiences.  The Service’s Regional Lead Officer had attended the Act Implementation Communications Steering Group.  This Group was focused on ensuring that a consistent message on the main implications of the Act was delivered to citizens across Wales. 

 

On 11th November, 2015, the Minister issued a written statement – ‘Update on Reform of the Arrangements for Paying for Social Care and Support’.  The Minister advised that due to the continued uncertainty about relevant UK reforms this had meant that he was not in a position to make informed decisions about the position in Wales.  However, WG would still move ahead with implementing an updated financial assessment and charging framework under the Act.  The regulations and Code of Practice relating to Parts 4 and 4 of the Act to introduce the updated framework were laid before the National Assembly on 3rd November, 2015.

 

The key elements of the framework included: 

  • one set of financial assessment and charging arrangements for non-residential and residential care and support rather than one for each at present;
  • maintaining the present weekly maximum charge and “buffer” for non-residential care and support, as well as the current capital limit used to determine who pays the full cost of their residential care themselves;
  • maintaining the current individuals, and forms of care and support, for which a charge could not be made and introducing a new provision of up to six weeks free reablement to enable a person to maintain or regain their ability to live independently so as to promote the prevention ethos of the Act;
  • introducing more transparency by extending the requirement for all those who receive a charge to receive a statement detailing this and its calculation;
  • introducing a consistent, universal review process to enable a person to query charges made and correct errors;
  • maintaining deferred payments in residential care to enable those whose property may need to be sold to pay for this to delay its sale until a time more appropriate for them; and by introducing the ability of a Local Authority to charge a low set rate of interest on the amount deferred.  This would help make such arrangements cost neutral to Authorities; and
  • allowing Authorities to recover charges and to create a charge over land where a debt occurs. 

The Director of Social Services further advised Members, that the Act had come out following an independent Commission which reported a position of strength within Social Services and that the Act was meant to improve the experience of service users.  The Act was being devised as a way to deal with the issues around changes to demographics and increasing demand and was based on the premise that investment in preventative and early intervention services would lead to individuals relying less on the ‘state’.  He commented that this view was not fully supported by evidence available to date and that the Act may, in the first instance, increase demand.   He mentioned that demand for acute health services was increasing, while also alluding to the pressure on resources available.  He stated that much of the responsibility around implementing the Act had been passed to Local Authorities and that the Service would implement as much of the Act as it could.

 

The Chairman referred Members attention to paragraph 13 of the report, which related to the urgent development of the national assessment and eligibility tool kit and he queried how this would be implemented in such a short time frame.  In answer to this, the Interim Head of Business Management and Innovation stated that initially the toolkit would be in the form of a checklist and so this would not require such a radical change to current systems as was previously envisioned.  This would allow the Service to implement the toolkit more quickly.

 

To follow up these points, the Director of Social Services explained that this was an example where the lead for implementation had been passed on to the Local Authorities.  In his view, this was rather belated, but that it was better for Local Authorities and local government as a whole to find national, regional and local solutions.  He also referred to how social care staff had become increasingly worried about how they would carry out their roles and that the Service needed to be able to reassure them that they would have the necessary tools to properly carry out their jobs.

 

In answer to a query regarding the number of red and amber actions within the Implementation Plan, the Director of Social Services stated that a major step forward was around the forging of links with Cardiff Council.  Implementation of the Act was on a regional basis and this had given the Service more capacity to tackle issues more quickly.  He explained that some of the major challenges were outside the control of the Council, but on the whole good progress was being made.  The Director also stated that he now felt that this was a more managed programme, which was down to the greater degree of autonomy that had been given to Local Authorities.  He further advised that it was likely that not all parts of the Act would be in place, but that this Authority was in a relatively good position.

 

Following consideration of the report the Committee

 

RECOMMENDED –

 

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

 

(2)       T H A T the Committee continue to receive regular updates about implementation of the Act.

 

(3)       T HA T Cabinet be advised of the latest progress around the approach being taken to implement the Social Services and Well-being (Wales) Act 2014. 

 

Reason for recommendations

 

(1-3)    To ensure that elected Members are kept informed about fundamental changes in policy and the legislative framework which underpins the work of Social Services.

 

 

616     QUARTER 2 SOCIAL SERVICES PERFORMANCE REPORT 2015-16 (DSS) –

 

The purpose of the report was to present Social Services performance results for Quarter 2, 1st April to 30th September, 2015-16.

 

The Social Services Directorate was well on track to achieving the objectives contributing to its service outcomes, with 81% of actions currently either completed or on track.  78% of the Corporate Plan actions were on track for completion (of the 9 Corporate Plan actions, 7 actions were on track and 2 had slipped.  There were 6 actions relating to the Improvement Objectives, of which 5 were on track, and 1 had slipped.  There were currently no Outcome Agreement actions.

 

Against Outcome 1, “People in the Vale of Glamorgan are able to request support and receive help in a timely manner”, 3 actions were reported slipped.  Limited progress was made during the quarter to increase the take up of assistive technologies such as Telecare due to staffing changes SS/A011 [(CP/HSCW5) (IO2)]. 

 

Work with the third sector and other organisations to deliver information about services for people in need via the Family Information Service had slipped this quarter [SS/A001 (CP/CYP6)].  This was due to uncertainties with regards to what would be expected from the Social Services and Well-being (Wales) Act 2014 and the implementation of Information, Advice and Assistance (IAA) part for which there had not been any further developments since the last quarter.  However, the IAA workstream would inform this objective and progress was anticipated in Quarter 3.

 

A meeting was planned with the Wales Co-operative Centre to facilitate a workshop to explore future service provider opportunities as part of our commitment to secure an increased range of service providers in social care, especially those who use a social entrepreneurial approach [SS/A015 (CP/H2)].

 

Against Outcome 2, “The Vale of Glamorgan Council protects vulnerable people and promotes their independence and social inclusion”, no actions were reported slipped.

 

Against Outcome 3, “Social Services in the Vale of Glamorgan review, plan, design and develop quality services that deliver best value for money to improve outcomes for individuals”, two actions were reported slipped.  Work to ensure that service specifications were derived from commissioning plans and that they were clear about the practice and quality standards expected.  There had been no further progress due to the absence of a Head of Business Management and Innovation and a Business Support manager. Work would recommence in Quarter 3 (SS/A039c).

 

In relation to the implementation of a brokerage hub for care home placements with Cardiff and Vale University Health Board (UHB) and Cardiff Council, a workshop was arranged but had had to be cancelled.  This project had recommenced during September/ October 2015 when the Interim Head of Service was appointed (SS/A043).

 

Of the 62 performance indicators that were measured quarterly, 37 (60%) had met or exceeded target, 8 (13%) were within 10% of target, and 13 (21%) had missed target by more than 10%.  Data was not available for 4 (6%) measures.  There were currently 4 performance Indicators relating to the Improvement Objectives; 2 had met / exceeded target, and 2 had missed target by more than 10%.  Of 10 Outcome Agreement measures for the Directorate, 6 had met / exceeded target and 4 had missed target by more than 10% this quarter.  The 13 indicators that had missed target related to:

 

  • SCA001: Whilst the rate of delayed transfers of care for social care reasons per 1,000 population aged 75 and over narrowly missed target this quarter. Progress had been made from last quarter, it was hoped that as a cumulative indicator would meet the annual target. 
  • SS/M004: Whilst the percentage of initial assessments that were completed during the year where there was evidence that the child had been seen by a worker missed target this quarter, it was noted that there would be situations where it was not always appropriate for a child to be seen during the initial assessment.  Therefore, performance was satisfactory in this context.
  • SCC010: In relation to the percentage of referrals that were re-referrals within 12 months, the Service was currently monitoring the decision to close a case, as the average length of time between referrals had been 6 months.
  • SS/M018: Whilst the number of new telecare users had missed target this quarter, this was a cumulative indicator and it was anticipated that the indicator would meet target in later quarters.
  • SS/M019a and SS/M019b: Both the rate per 1,000 of population of over 65s who had had a UA and OT assessment had missed target this quarter were due to changes in procedure.
  • SS/M024: The percentage of reviews of child in need plans carried out in accordance with the statutory timetable had slipped this quarter.  This indicator had been deleted from the Welsh Government returns for 2015-16, in preparation for the measuring of performance under the Social Services and Well-being (Wales) Act.  In 2015-16, the performance data was being monitored under local management information, not as a performance measure, and would be deleted from the framework in 2016-17.
  • SS/M028: The average time taken to complete initial assessments that took longer than 7 working days had missed target for this quarter. This indicator had been deleted from the Welsh Government returns for 2015-16, in preparation for the measuring of performance under the Social Services and Well-being (Wales) Act.  In 2015-16, the performance data was being monitored under local management information, not as a performance measure, and would be deleted from the framework in 2016-17.
  • SS/M029: The percentage of required core assessments completed within 35 working days. This indicator has been deleted from the Welsh Government returns for 2015-16, in preparation for the measuring of performance under the Social Services and Well-being (Wales) Act.  In 2015-16, this data was being monitored as local management information and would be deleted from the framework in 2016-17.
  • SCC039:  The percentage of health assessments for Looked After Children (LAC) due in the year that have been undertaken.  CYPS officers had met with the designated Doctor for LAC to review performance and to agree a mechanism for improvement.  These discussions had confirmed that all LAC were offered a health assessment, but that not all take place within timescale. There was now greater clarity regarding the reasons why health assessments did not take place, 64.88% of health assessments were completed within timescale (4 weeks), this increased to 71.76% when those assessments completed within a calendar month were included; and to 76.47% when all children who had a health assessment were included.  Reasons for late and non-completion would continue to be monitored with the intention of further improving performance.
  • SCC043b: The average time taken to complete those required core assessments that took longer than 35 working days.  This indicator had been deleted from the Welsh Government returns for 2015-16, in preparation for the measuring of performance under the Social Services and Well-being (Wales) Act.  In 2015-16, the performance data was being monitored under local management information, not as a performance measure, and would be deleted from the framework in 2016-17.
  • SCC011b: The percentage of initial assessments that were completed during the year where there was evidence that the child had been seen alone by the social worker.  Although this target was missed, there would be situations where it was not always appropriate for a child to be seen during the initial assessment.  Performance was satisfactory in this context.
  • SCC033f:  The percentage of young people formerly looked after with whom the Authority is in contact, who were known to be engaged in education, training or employment at the age of 19.  Of the ten young people not in education, employment or training; three were currently unable to work due to illness / disability and one was a young parent.  Social Services were currently working with the remaining six young people to provide help and support in finding suitable education, employment or training opportunities.

The Chairman, referring to performance indicator SCC339 (the percentage of health assessments for Looked After Children during the year that had been undertaken), queried as to what the issues were that were affecting the performance and how did the Vale’s performance compare to that of Cardiff which shared the same local health board.  In response to this, the Head of Children and Young People Services stated that Cardiff did not monitor their performance on a quarterly basis, so current figures were not available for comparison, but she indicated that the Vale’s performance was not significantly below Cardiff’s.  She went on to explain that there were a number of reasons why a child or young person may not have a health assessment within the required timescales.  This included instances where the child or young person was placed out of area, which required the co-operation of staff from other Health Boards.  Also, there were occasions when the child or young person refused a health assessment. 

 

She also explained that a detailed explanation on the performance was shown within the Appendix and that she had a good relationship with colleagues in Health and that open discussions were taking place as to how to improve the way health assessments were completed.

 

In reply to a follow-up query regarding instances when a child or young person refused a health assessment, the Head of Children and Young People Services stated that this would be an on-going process which would require continued dialogue between the child and the social worker.  She further advised that, as this was a cumulative indicator, there was an opportunity for performance to improve.  It was also recognised that improvement remained a priority.  At this point, the Cabinet Member informed the Committee that, as he was a member of the Cardiff and Vale Local Health Board, he or the Cabinet Member for Children Services and Schools would raise this at the next Board meeting. 

 

The Director of Social Services then advised that it was useful to explain to Members as to what exactly a health assessment was.  This did not relate to the ongoing treatment of a child’s health issues but was more of a planning tool used to meet the needs of the child or young person.  He stated that, given the concerns of the Committee and also the CSSIW, it would be proper for him to lead on this and to bring this to the attention of the Cardiff and Vale Local Health Board. 

 

A Committee Member asked if officers could comment on performance indicator SCA/001 (the rate of Delayed Transfers of Care for social care reasons per 1,000 population aged 75 and over).  In reply, the Head of Adult Services advised Members that Quarter 1 performance for this year was not as strong as performance seen during 2014/15.  He stated that Quarter 2 performance was better but as this was a cumulative figure the end of year performance for this year may not be as good as last year’s performance.  In querying the reasons which could impact on the performance for this indicator, he stated that it was not right to make a judgement on one quarter’s performance.  He advised that staff resilience could be a factor, where sickness was usually the main reason, and that this would be addressed.

 

In relation to this query, the Cabinet Member advised that it had been identified within the Health Board that there were 70 individual steps within hospital processes in which a delay could occur.  He commented that the Vale was doing well in this indicator and that he agreed with the Head of Adult Services’ point that, on some occasions, staff issues could affect people being discharged from hospital.  He also commented that he would prefer it for five people to be delayed by a week than for two people to be delayed for over a year, and that the sooner a person was out of hospital the better. 

 

The Committee queried the performance of indicators SS/M019a and SS/M019b, which related to the rate of Unified Assessments and Occupational Assessments completed per 1,000 of the population aged over 65.  Members heard that the reason these had missed target was as a result to changes in procedure, which specifically related to the implementation of the new Integrated Assessment Guidance and associated I.T. changes.

 

Finally, the Committee noted that a number of indicators had been deleted from Welsh Government returns for 2015-16 following preparation for the measuring of performance to be stipulated under the Social Services and Well-being Act.  Performance data for these indicators would still be monitored by the Service.

 

RECOMMENDED –

 

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

 

(2)       T H A T the progress to date in achieving key outcomes as outlined the Corporate Plan 2013-17, the Outcome Agreement 2013-16 and the Improvement Plan Part 1 2015-16 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 Measure (Wales) 2009.

 

(2)       To consider the Quarter 2 Social Services performance results as at 30th September, 2015 in order to identify service areas for improvement.

 

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