Agenda Item No. 8
The Vale of Glamorgan Council
Scrutiny Committee (Social Care and Health): 7th November, 2013
Report of the Director of Social Services
Sustainable Social Services for Wales: A Framework for Action and the Social Services and Wellbeing (Wales) Bill
Purpose of the Report
1. To provide Scrutiny Committee with an update in respect of the Local Government Implementation Plan for Sustainable Social Services and to outline the current position regarding the Social Services and Wellbeing (Wales) Bill.
That Scrutiny Committee:
1. Notes the report.
2. Continues to receive regular updates about the progress made in achieving the actions set out in Local Government Implementation Plan for Sustainable Social Services and the Social Services and Wellbeing (Wales) Bill.
Reason for the Recommendations
1-2. To ensure that elected Members are kept informed about fundamental changes in the policy and legislative framework which underpins the work of Social Services.
Sustainable Social Services for Wales – A Framework for Action
2. 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".
3. In the strategy, setting out Welsh Government plans "to renew social services and social care for the next decade", the Deputy Minister made 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. The strategic plan concludes that wholesale structural change is not necessary and that local government will continue to be accountable for service delivery, identifying need and determining service priorities. However, steps to reshape social services are required, in response to factors such as changes in family structures; demography; expectations about service user control; more fragmented communities and the impact of issues like substance misuse.
4. At Section 3, the strategy sets out eight priorities for action to be introduced in support of renewal. In summary, these 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.
5. The strategy acknowledges that social services and social care are facing real and unsustainable increases in demand across all categories of service users. It concludes that, as the public sector financial outlook is so bleak, 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.
6. In response to the strategy, local government developed a comprehensive Implementation Plan, describing its commitments in respect of the Government agenda. Jointly submitted by the Welsh Local Government Association (WLGA) and the Association of Directors of Social Services (ADSS) Cymru in October 2012, the plan combines the delivery of regional programmes alongside national projects, with clear political and professional ownership. The Deputy Minister described it as "a landmark document which demonstrates the absolute commitment of local government to transforming social services in Wales". Specific commitments within the Plan range from improving commissioning of social care, through building management capacity to meet the challenges of the emerging agenda, to developing new service models for children, adults and older people predicated on broad principles of prevention and reablement and designed to improve outcomes for individuals and reduce demand on core services.
7. Delivery of the Plan is monitored by an Implementation Board chaired by the WLGA Spokesperson for Health and Social Care. Regular reports on progress are provided to two national strategic leadership groups established by Welsh Government (the National Social Services Partnership Forum and the Strategic Leadership Group), which are meant to resolve emerging concerns.
8. This Scrutiny Committee considered the Implementation Plan in January 2013 and asked for regular updates. The latest monitoring report was endorsed by the Implementation Board in September and a copy is attached at Appendix 1. It highlights considerable progress; most commitments are being delivered within agreed timescales. The Plan continues to be recognised as making a major contribution to delivery of Sustainable Social Services in Wales. However, the update report also identifies risks to further progress and provides a commentary about how these might be addressed. In response, ADSS Cymru has made a commitment to helping provide a substantially revised version, one which gives particular regard to the changes likely to be initiated by the Social Services and Wellbeing (Wales) Bill.
The Social Services and Wellbeing (Wales) Bill
9. The Social Services and Wellbeing (Wales) Bill was introduced to the Welsh Assembly in January 2013. It seeks to consolidate and rationalise existing legislation affecting social services and to provide a single, unified legislative framework for delivery of the Sustainable Social Services agenda.
10. Social care is located within a wider framework of "wellbeing", placing a new duty on local government to provide care and support for "people in need" and emphasising the important role of prevention. Hence, the Bill carries significant implications not just for Social Services but also for other local government services and the wider public sector.
11. The Bill has just passed through the first stage of scrutiny in the Assembly. The Stage 1 Report by the Health and Social Care Committee Web site link is attached. http://assemblywales.org/bus-home/bus-business-fourth-assembly-laid-docs.htm?act=dis&id=248230&ds=7/2013 The report contains over 60 recommendations which AMs wish to see accepted by the Deputy Minister and reflected in the Bill through amendments introduced during Stage 2 scrutiny.
12. During a plenary debate on the general principles of the Bill on 8th October, all Members of the National Assembly had an opportunity to vote on the Stage 1 report after the Deputy Minister had set out her response. Members from all parties welcomed the principles underpinning the Bill but there were still questions about the comprehensive scope of the Bill and the lack of detail that has been available to date, particularly in areas such as Eligibility and Assessment. AMs continued to express concerns about the financial implications, especially in light of the budget settlement announced the day before by Welsh Government. The vote was passed and the Bill will now proceed to Stage 2 scrutiny, where AMs may table amendments.
13. In response the Deputy Minister committed to issuing a series of statements on key aspects of the Bill over the coming months and these are outlined below:
· review of the balance between Primary and Subordinate Legislation;
· consequential and issues of securing competence from Westminster (i.e. to pass legislation relating to the police);
· major statement on eligibility and assessment (OCTOBER);
· safeguarding (END OF OCTOBER);
· regulation and guidance for complaints;
· statement on prevention and early intervention (22nd NOVEMBER);
· statement on children’s social care (29th NOVEMBER);
· statement on finance and funding (JANUARY);
· carers (JANUARY);
· cross-border care and portability (JANUARY).
14. In consultation with key partners, the WLGA has issued a set of proposed draft amendments and these are set out in the report at Appendix 2. The Bill is expected to become statute in early 2014.
Relevant Issues and Options
15. While the broad aims of the Bill have attracted considerable support, there is still much disquiet about how such a comprehensive programme of change can be managed and delivered, especially given the state of public sector finances for the foreseeable future. Welsh Government maintains that, in the longer-term, implementing the Bill will be cost neutral. This is predicated on a conviction that a focus on wellbeing, prevention and the provision of information and advice will divert and reduce demand for current and more expensive forms of care and support.
16. In its stage 1 Report, however, the Health and Social Care Committee concluded that: "We are not satisfied with the information that has been made available on the total cost of the Bill and have not received any evidence to convince us that the Bill will be cost neutral in the long term. We are mindful that the size and complexity of the Bill make it extremely difficult to cost. We also recognise the concerns of witnesses with regard to the current challenges facing public sector funding which will shape the context within which this Bill is delivered."
17. The WLGA commissioned an independent report from the Institute of Public Care called "Transitional and longer-term implications of the Social Services and Wellbeing (Wales) Bill September 2013". Attached is the Web site link to the report. http://www.wlga.gov.uk/health-social-services-publications/transitional-and-longer-term-implications The report represents the best effort to date at providing a realistic appraisal of the current context for social services, the Bill’s likely impact, the costs of transformation and the significant challenges that must be overcome. It argues that, without the implementation of the wellbeing agenda at the heart of the Bill, local partners will struggle to meet the demands placed on them through changing demographics and welfare reform while implementation of other elements such as new assessment and Direct Payments arrangements could prove to be costly.
18. The report explores the key implementation issues that the Welsh Government, local authorities and the NHS may need to consider as they look to work together to make the aspirations of the Bill a reality in the current climate. For local authorities, the key tasks are:
· Undertake a rigorous self-assessment and agree a plan for service development with local area partners.
· Agree the forms of local integration most needed to deliver the changes in pathways and services to secure better outcomes for citizens.
· Explore with citizens and with local third sector partners how to create a culture of engagement and greater co-production in services.
· Undertake a local cost-benefit analysis of their development plans and review budgets accordingly.
· Place wellbeing at the heart of service provision.
· Develop a commissioning strategy to realign services to focus on early intervention and prevention, and improve outcomes.
· Seek to develop and commission services which offer cost-effective and integrated solutions to care.
· Develop local arrangements which fit the proposed assessment and eligibility framework and support staff through guidance and training.
· Review existing information systems and information sharing protocols and identify improvements needed.
· Develop and strengthen their partnership working across a range of agencies.
· Respond to the demands of developing a "whole" council approach to service delivery.
· Work with the third sector to deliver cost-effective public services.
19. Social Services are facing unprecedented pressures in terms of demand for services (actual and projected), increased public expectations, demographic change, significant new duties being introduced through the forthcoming legislation and, in common with other parts of the public sector, severely constrained financial resources. This presents formidable challenges in an environment in which some councils are already recording overspends in their Social Services budgets. The impact of welfare reforms is increasing even more the need for help from social services and its partners.
20. From the start, local government has been clear about the essential building blocks for social services reform. For this Bill to deliver on its promises, it must simplify the law, make clear the core functions of social services, streamline bureaucracy, balance national consistency and local autonomy, require key partners such as health and social services to work together far more closely in meeting people’s needs within their own homes and communities and define how wellbeing and preventative responsibilities will be shared equitably across the public and third sectors in Wales. Only with the best possible legislation can the Welsh Government, local government and our partners turn ambitious plans and principles into an everyday reality for the people who will need care and support services in the future.
21. Clearly, implementation will be complicated, requiring a whole system change and new models of care in local areas. Transformational change is never easy. Efforts to modernise services face many obstacles, including:
· budgetary pressures and the need for savings;
· potential opposition from service users and carers who value existing provision highly and depend upon it for an improved quality of life;
· encouraging current service providers from all sectors to change their approach;
· the scale of the agenda, with a need to focus on innovation and continuous improvement in all areas of service design, delivery and evaluation;
· difficulties in finding the resources required to bring about transformational change;
· the clear risks that the new legislation will impose increased costs; and
· the risks of cost shunting from the NHS and other partners, including central government.
22. The programmes of work undertaken in the Vale and in our collaborative enterprises such as the South East Wales Improvement Collaborative (SEWIC) and the Integrating Health and Social Care Improvement Board place this Council in a good position for responding positively to increased emphasis on implementing new service models. Wherever possible, we are in the forefront of efforts to reshape the range of social care services available, based upon agreed principles:
· an emphasis on promoting preventative services which divert people from inappropriate and higher cost provision, 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.
23. However, Welsh Government strategy is predicated on an assertion that there is a choice between retrenchment and renewal. In the absence of a more sustainable solution to the question about how the costs of social care are to be met in the longer-term, it seems likely that both options will have to form part of any realistic approach, requiring as many people as possible to take increased responsibility for meeting their own needs so that the most vulnerable can be safeguarded from harm.
Resource Implications (Financial and Employment)
24. There are no resource implications as a direct consequence of this report. However, both "Sustainable Social Services for Wales – A Framework for Action" and the Social Services and Wellbeing (Wales) Bill 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, apart from limited transitional funding. 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)
25. There are no legal implications as a direct result of this report.
Crime and Disorder Implications
26. There are no crime and disorder implications as a direct result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
27. "Sustainable Social Services for Wales – A Framework for Action" 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.
28. 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
29. These are matters for Executive decision by Cabinet.
Consultation (including Ward Member Consultation)
30. There are no matters in this report which relate to an individual ward.
Scrutiny Committee Report 14th January, 2013: Sustainable Social Services for Wales: A Framework for Action
Philip Evans, Director of Social Services
Corporate Management Team
Philip Evans, Director of Social Services