Agenda Item No
The Vale of Glamorgan Council
Scrutiny Committee (Social Care and Health): 31st October, 2011
Report of the Director of Social Services
Sustainable Social Services for Wales: A Framework for Action
Purpose of the Report
1. To provide Scrutiny Committee with an update in respect of "Sustainable Social Services for Wales – A Framework for Action", a Welsh Government policy document which sets out plans "to renew social services and social care for the next decade."
That Scrutiny Committee:
1. Notes the paper.
Reason for the Recommendation
1. To ensure that Scrutiny Committee receives regular updates in respect of this major policy statement by the Welsh Government, outlining the programme of change that it proposes to pursue in respect of social services.
2. On 17th February, 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 the paper is attached at Appendix 1. Cabinet received a report on 16th March, outlining the contents of the plan, and the matter was then discussed in this Committee on 23rd May.
3. Several recent policy reviews contributed evidence to the plan, including:
· The Independent Commission for Social Services;
· Social Work and Social Care Workforce Task Group;
· National Safeguarding Children’s Forum; and
· The Protection of Vulnerable Adults Project Group
4. In the paper, the Deputy Minister makes it clear that the changes are needed, not because social services are in some way broken but because of significant changes in the social and financial context within which they are delivered. This was also the conclusion reached by the recent Independent Commission which painted a picture of a service with considerable strengths, many of which are derived from its position at the heart of local government. Wholesale transformation and structural change are not necessary. Steps to reshape social services are required, however, as a response to factors such as changes in family structures; demography; expectations about service user control; more fragmented communities and the impact of issues such as substance misuse.
5. Social services and social care are facing real and unsustainable increases in demand. The numbers of looked after children and those on the child protection register are growing. The number of people registered with local authorities in Wales as having a learning disability is increasing. There is an rising number of older people with complex care needs who can benefit from support and whose support needs are extensive. The financial outlook is difficult and so it is not possible to buy a way forward.
6. The policy paper concludes that the choice is 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 is responsible for services. Renewal means focusing more clearly on delivery (including preventative services), continuing to innovate and creating sustainable services.
7. Sustainable Social Services for Wales – A Framework for Action sets out, at Section 3, eight priorities for action that will be introduced in support of renewal. In summary, the priorities are:
· 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; and
· a new improvement framework.
8. Some of the policy changes can be achieved within existing legislation; some will require changes to regulations or to primary legislation. Others have implications for non-devolved services and may require Wales and England changes. The paper acknowledges that the implementation plan must also take into account other important initiatives that will have a major impact on social services. The list includes the Dilnot Commission, which is looking at how people across the UK can contribute to their long-term care costs in a fair and sustainable way. Any major reform will need to be led by the UK Government as key areas such as taxation, National Insurance and welfare benefits are within its remit. The Commission reported this summer 2011 but there has been no official response as yet by the UK government. Additionally, the Family Justice Review (jointly commissioned by Welsh and English Ministers) will have a significant impact upon children’s social services.
9. The paper contains a number of messages similar to those set out in the report of the Independent Commission for Social Services. This report met with much approval within local government and beyond. It acknowledged the considerable gains and sustained progress made in recent years in areas such as improved leadership within councils, a better qualified workforce with skills that enable them to work across organisational boundaries, a more responsive range of services available, more systematic matching of resources to needs, greater service user satisfaction , and greater innovation. In setting the overall policy direction, "Sustainable Social Services for Wales – A Framework for Action" acknowledges these improvements and emphasises that local government will continue to be accountable for service delivery, identifying need and determining service priorities.
10. However, according to the paper, the Welsh Government intends to oversee some changes in governance arrangements for social services. It will take greater responsibility for driving the direction of services, within a new framework of national outcomes. It "will ensure that everything is not done 22 times"; there will be clear expectations that more services will be planned, commissioned and delivered on a regional or even a national basis. The number of partnerships will be greatly reduced. By the end of 2011, local government must present outline proposals for the way in which these expectations can be met.
11. In response to a request from the Deputy Minister to all local authorities, asking Leaders how they were going to lead and implement those parts of ‘Sustainable Social Services’ which fall to local government to take forward, Councillor Kemp provided her in July with an account of the way in which the Vale of Glamorgan is responding. She was encouraged by the level of our commitment and interested to see the examples of existing collaborative projects and services, demonstrating again that we have a firm base upon which to build improvement. However, she also made it clear that doing more of the same will not deliver the changes that are required and that "we must go further and faster and deliver with less", with the emphasis on collaborative action and "clear and realistic proposals to deliver local, regional and national change". There is an expectation that, in December, local government will respond with one voice, co-ordinated by the Welsh Local Government Association (WLGA). This does not preclude individual responses from local authorities, detailing existing and proposed activity at local and regional levels.
12. The collective response will be put to Leaders for endorsement at the WLGA Council on November 25th. In working up the response, WLGA will be working through the following mechanisms:
· Social Services Lead Members Group;
· WLGA Regional Boards via Lead Chief Executives;
· Association of Directors of Social Services (ADSS Cymru); and
· Chairs of the Social Services Improvement Collaboratives.
Relevant Issues and Options
13. The collaborative agenda for local authorities set out in Sustainable Social Services for Wales – A Framework for Action is very congruent with the work being done by the Vale in the South East Wales Improvement Collaborative (SEWIC) and the partnership with Bridgend County Borough Council. The plan also proposes that the Welsh Government will 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 places this Council in a good position for responding positively to increased emphasis on implementing new service models.
14. Similarly, the agenda for change in respect of other priority areas set out in the strategic plan matches closely the direction established for the Vale in last year's annual report of the Director of Social Services. These include:
· 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; and
· 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.
15. Cabinet has already endorsed the new three-year change plan which is based upon this agenda, providing an overarching framework for sustained improvement and a coherent direction for social services in the Vale.
16. However, if many of the proposed changes set out in Sustainable Social Services for Wales – A Framework for Action are likely to assist us in promoting improvement, this is often at the level of principles and goals. In the relatively few areas where the strategy is more specific, there is some cause for concern. For example, where a regional approach is necessary, the paper sees merit in using the "footprint" of the Local Health Boards. This needs more debate, given that the LHB framework for NHS services is only two years old and it is already encountering problems in some areas. Additionally, plans to introduce portable assessments may require the Welsh 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 is difficult also 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 is crucial. A framework of national outcomes to replace detailed targets is welcome but we do need to ensure that the system is not overly reliant on unhelpful proxy measures such as the rate of people receiving support from social services.
17. Moreover, the strategy is predicated on an assertion that there is a choice between retrenchment and renewal but there is no economic or business case to demonstrate this premise to be true. There is strong evidence that the current systems underpinning the provision of social care are fundamentally broken, especially the economic model given the failure to deal with issues around paying for care. Increasingly, local authority social services are experiencing the impact of a depressed economy, which simultaneously generates increasing demand for services (in addition to demographic trends) and reduces the resources available.
18. In response to this crisis, the Vale of Glamorgan is in the forefront to efforts to reshape the range of services, based upon agreed principles:
· an emphasis on promoting preventative services which divert people from inappropriate and higher cost provision or manage demand at lower levels of intensity/intrusiveness and which can be accessed without complex assessments;
· clear tiers of services, with known thresholds; and
· 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. However, progress is being made in reshaping service models.
19. The work being done here to develop new models of care has clear merits:
· providing opportunities for radical and creative thinking about how services are delivered, encouraging dialogue and getting consensus about overall direction;
· providing a way of establishing priorities and clarity for staff, partners and service users/ carers; and
· acting as a precursor for decisions about investment of resources and commissioning.
20. The three-year change plan for social services will help us 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 has encouraged a whole systems approach to problem solving, lessening the grip of traditional organisational silos and helping us to develop integrated models of health and social care for Older People. Relevant agencies locally demonstrate increasing acceptance of social recovery models in Mental Health and valuing people approaches in Learning Disabilities. We are pioneers in establishing a coherent approach to the preventive, protective and remedial initiatives contained in the Child Poverty Strategy (Flying Start, Families First and the Integrated Family Support Service). The Vale has taken a leading role in taking forward the work of the regional improvement collaborative.
21. We are building on acknowledged strengths but the only way to deal effectively with a context where the need for social care is growing rapidly and resources are not keeping pace is a combination of reshaping services to divert demand, retrenchment and reducing costs. Additionally, efforts to modernise services face many obstacles. Our budget management is repeatedly undermined by new WG initiatives that are often ill-conceived and not costed properly. Our key partners in the NHS have not been able as yet to stop the acute hospital sector sucking up and retaining a disproportionate share of resources.
22. Dialogue with the Welsh Government about these issues to date has not been very productive. In some areas, such as the shape of regional collaboration, there has emerged growing inflexibility on their part. However, officials have recognised the need for help from local government in taking forward Sustainable Social Services for Wales – A Framework for Action as a five-year programme of change. This is even more the case given the intention to introduce a Social Services (Wales) Bill, which has been announced as forming part of the Welsh Government’s legislative programme for 2012/13.
23. The Bill is intended to provide the legal architecture to deliver ‘Sustainable Social Services for Wales: A Framework for Action’. It will 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; and
· the regulation and inspection of bodies/professionals who provide care services.
24. To take forward this very ambitious agenda, the Deputy Minister has set up the National Social Services Partnership Forum (for Elected Members) and a corresponding Leadership Group (for officers, including ADSS Cymru). These are regarded as key vehicles to present early views and discuss key issues with wider stakeholders. Membership of the Forum includes the leadership of key bodies involved in social services in Wales and, from the WLGA, cabinet members from five main political groups (including the Vale of Glamorgan Cabinet member for Social Care and Health).
Resource Implications (Financial and Employment and Climate Change, if appropriate)
25. There are no resource implications as a direct consequence of this report. However, the paper does set a whole range of new challenges; these will have to be met at a time of severe financial restraints for local government and social services. It has been made clear that there will be no additional resources from the Welsh Government for this purpose. It is right to remain very cautious about whether there will be sufficient resources available to meet increased commitments and expectations in the face of growing demand for services.
Legal Implications (to Include Human Rights Implications)
26. There are no legal implications as a direct result of this report.
Crime and Disorder Implications
27. There are no crime and disorder implications as a direct result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
28. The paper recognises the diversity of Wales, including its status as a bilingual nation, and a task group has been established on the Welsh language and social services.
29. Social services meets the following corporate objectives:
· "To make the Vale a safe, healthy and enjoyable place in which individuals, children and families can live their lives to the full"; and
· "To manage the Council's workforce, money and assets efficiently and effectively in order to maximise its ability to achieve it service aims."
Policy Framework and Budget
30. These are matters for Executive decision by Cabinet.
Consultation (including Ward Member Consultation)
31. There are no matters in this report which relate to an individual ward.
Cabinet Meeting 19th January, 2011: Report of the Independent Commission on Social Services in Wales: From Vision to Action
Cabinet Meeting 16th March 2011,
Minutes of Social Care and Health Scrutiny Meeting on 23rd May.
Philip Evans, Director of Social Services
Philip Evans, Director of Social Services