THE VALE OF GLAMORGAN COUNCIL
CABINET: 4TH MARCH, 2013
REFERENCE FROM SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH): 11TH FEBRUARY, 2013
“846 SUSTAINABLE SOCIAL SERVICES FOR WALES: A FRAMEWORK FOR ACTION (DSS) –
Committee were provided with an update in respect of “Sustainable Social Services for Wales – A Framework for Action”, the Welsh Government policy document which set out plans “to renew social services and social care for the next decade”.
In February 2011, the Deputy Minister for Social Services announced a new strategic plan for putting social services on a sound footing, “Sustainable Social Services for Wales – A Framework for Action”, a copy of which was attached at Appendix 1 to the report.
The policy paper concluded that the choice was either retrenchment or renewal. Retrenchment would see fewer people receiving services, greater expectations that people find their own solutions, increased burdens on informal carers and a growing number of disputes between services such as the NHS and social care about who was responsible for services. Renewal meant focusing more clearly on delivery (including preventative services), continuing to innovate and creating sustainable services.
Section 3 of the paper set out eight priorities for action that would be introduced in support of renewal. In summary, the priorities were:
· a strong national purpose and expectation, and clear accountability for delivery
· a national outcomes framework
· citizen centred services
· integrated services
· reducing complexity
· a confident and competent workforce
· safeguarding and promoting the wellbeing of citizens
· a new improvement framework.
On 31st October 2012, Welsh Local Government Association (WLGA) and the Association of Directors of Social Services (ADSS) Cymru produced for the Deputy Minister a final Local Government Implementation Plan for Sustainable Social Services. This provided a detailed framework for delivering a range of commitments spanning the next two years. A copy of the Plan was attached at Appendix 2 to the report. The Bill was intended to provide the legal architecture to deliver “Sustainable Social Services for Wales: A Framework for Action”. It would bring together, into a single unified legal framework:
· the duties of local authorities and their partners to safeguard and promote the wellbeing of people and their functions in relation to social care
· key processes of social work practice
· the regulation and inspection of bodies / professionals who provide care services.
The collaborative agenda for local authorities set out in Sustainable Social Services for Wales – A Framework for Action was very congruent with the work being done by the Vale in the South East Wales Improvement Collaborative (SEWIC). The plan also proposed that the Welsh Government would prioritise integrated services, in particular for families with complex needs, looked after children, transition to adulthood and frail older people. Here again, the work of the Integrating Health and Social Care Improvement Board placed this Council in a good position for responding positively to increased emphasis on implementing new service models.
Similarly, the agenda for change in respect of other priority areas set out in the strategic plan matched closely the direction established for the Vale in last year’s annual report of the Director of Social Services. These included:
· citizen centred services – with users and carers having a much stronger voice and greater control over their services but without the English system of personal budgets
· a confident and competent workforce – more confident in its own professional judgement and with a reduced volume of prescriptive government guidance about processes
· safeguarding and promoting the wellbeing of citizens – cutting complexity by reducing the number of Local Safeguarding Children Boards and joining up the adult protection and children’s safeguarding agendas.
However, if many of the proposed changes set out in the document were likely to assist in promoting improvement, this may often be at the level of principles and goals. In the relatively few areas where the strategy was more specific, there was some cause for concern. For example, plans to introduce portable assessments may require the Welsh Assembly Government to resolve fundamental issues about the use of different eligibility criteria by local authorities and discrepancies in the resources made available to them for the provision of social services. It was also difficult to reconcile the wish to introduce more elements of a national social care service and the emphasis upon greater corporate working within local authorities to promote wellbeing and social inclusion. Getting the correct balance between national prescription and flexibility for local determination was crucial.
Moreover, the strategy was predicated upon an assertion that there was a choice between retrenchment and renewal but without an economic or business case to demonstrate this premise to be true. There was strong evidence that the current systems underpinning the provision of social care were fundamentally broken, especially the economic model given the failure to deal with issues around paying for care and the scale of the financial challenges which local government faces in meeting in full the duties placed upon it by statute and regulation. In response to this crisis, the Vale of Glamorgan was in the forefront to efforts to reshape the range of social care services it provided, based upon agreed principles:
· an emphasis on promoting preventative services which divert people form inappropriate and higher cost provision or mange demand at lower levels of intensity / intrusiveness and which could be accessed without complex assessments
· clear tiers of services, with known thresholds
· service models which are underpinned by the concepts which service users and others believe are necessary to underpin a dignified life, independence, choice and control, wellbeing, social inclusion.
The work being done in this Council to develop new models of care had clear merits:
· providing opportunities for radical and creative thinking about how services were delivered, encouraging dialogue and getting consensus about overall direction
· providing a way of establishing priorities and clarity for staff, partners and service users / carers
· acting as a precursor for decisions about investment of resources and commissioning.
The three year change plan for social services was helping the Directorate to tackle the overall strategic agenda required, especially in developing the tools needed for reshaping services, with better links between planning and partnerships, commissioning and contracting and resources management. Recent work undertaken with the Social Services Improvement Agency to emphasise reablement and restoration had encouraged a whole systems approach to problem solving, lessening the grip of traditional silos and helping the Directorate to develop integrated models of health and social care for Older People. The vale had taken a leading role in taking forward the work of the regional improvement collaborative.
The Directorate was building on acknowledged strengths, but the only way to deal effectively with a context where the need for social care was growing rapidly and resources were not keeping pace was a combination of reshaping services to divert demand, retrenchment and reducing costs. Efforts to modernise services faced many obstacles, including:
· budgetary pressures and the need for savings
· finding the resources required to bring about transformational change
· the risks that new legislation will impose increased costs
· the scale of the agenda, with a need to focus on innovation and continuous improvement in all areas of service design, delivery and evaluation
· the risks of cost shunting from the NHS and other partners, including central government.
It was important, therefore, that local government collectively asserts considerable influence over the programme of change in social services and takes control of key elements where possible. Operational delivery of the service commitments in the Implementation Plan would be led by ADSS Cymru with a specific contribution from the Social Services Improvement Agency in relation to building strategic capability and supporting service transformation. The Welsh Government was currently undertaking a review of Social Services improvement capacity across Wales and it was essential that the case be made for retaining improvement capacity within local government to ensure delivery of our commitments. ADSS Cymru operated from a strong base in local government. Directors worked through the governance and accountability structures within their own local authorities and those endorsed regionally and nationally by Leaders, Executive / Cabinet Members and Chief Executives. ADSS Cymru would be able to supply consistent professional leadership and best use of collective knowledge and experience. WLGA would seek to provide strong political accountability and leadership for the programme, information for Elected Members and improvement support.
(1) T H A T the contents of the report be noted.
(2) T H A T Committee receives regular updates about the progress made in achieving the actions set out in the Local Government Implementation Plan for Sustainable Social Services, jointly submitted to the Deputy Minister for Children and Social Services by the Welsh Local Government Association and the Association of Directors of Social Services Cymru.
(3) T H A T Cabinet be recommended to endorse the Local Government Implementation Plan.
Reasons for recommendations
(1&2) To ensure that Scrutiny Committee receives regular updates in respect of this major policy statement by the Welsh Government and the actions taken within local government to achieve the commitments to action contained in its Implementation Plan.
(3) To demonstrate the Council’s approval of the specific commitments to action set out in the Local Government Implementation Plan.”
Attached as Appendix - Report to Scrutiny Committee (Social Care and Health): 11th February 2013