SCRUTINY COMMITTEE (COMMUNITY WELLBEING AND SAFETY)

 

 

MINUTES of an extraordinary meeting held on 10th December, 2007.

 

Present: Councillor Mrs. M.E.J. Birch (Chairman); Councillor K.R. Stockdale (Vice-Chairman); Councillors Mrs. S.M. Bagstaff, Ms. R.M. Birch, Ms. L. Burnett, P. Church, J. Clifford, H.J.W. James, G.C. Kemp, A.G. Powell, Mrs. A.J. Preston, J.W. Thomas and W.C. Vaughan.

 

Also present: Councillor S.C. Egan.

 

 

603     APOLOGIES FOR ABSENCE -

 

These were received from Councillors R.J. Bertin, Mrs. A.J. Moore, B.I. Shaw and Cabinet Member Councillor Mrs. M.R. Wilkinson.

 

 

604     DECLARATIONS OF INTEREST -

 

No declarations were received.

           

 

605     REPORT OF THE WALES AUDIT OFFICE TACKLING DELAYED TRANSFERS OF CARE (CX) -

 

The purpose of the report was to advise Members of the outcome of a study by the Wales Audit Office on delayed transfers of care (DToC) in Cardiff and the Vale of Glamorgan.  The Wales Audit Office had conducted a cross-cutting inspection into DToC across the Cardiff and Vale of Glamorgan Councils, the Local Health Boards and Cardiff and Vale and Bro Morgannwg NHS Trusts.  A copy of the summary including recommendations of the Cardiff and Vale report was attached as Appendix 1.  Members were also advised that a copy of the full report for Cardiff and the Vale of Glamorgan was available on the following website:

 

http://www.wao.gov.uk/assets/englishdocuments/DToC_Cardiff_Eng.pdf

 

and the full overview report was available at:

 

http://www.wao.gov.uk/assets/englishdocuments/DToC_Overview_eng.pdf

 

Delayed transfers of care occurred when there were delays in moving a patient from an acute health care setting to an alternative setting when they were medically fit to do so.  Delays in transferring people could mean that people could lose their independence, tie up resources in hospital beds and affect hospital waiting times.  The many reasons for delays were detailed as health reasons, social care, legal or choice and family reasons.  The study found that the impact of lost beds through delayed transfers of care was on the increase however it was noted that the number of patients living in the Vale that had experienced DToC fell between 2005/06 and 2006/07 and in the same period over 4,000 extra bed days were lost an increase of 22% between the two years.  The average length of delay had risen from around 60 days to more than 80 days.  The officer presenting the report highlighted that the figures that had been used by the Wales Audit Office for analysing DToC were for the financial years 2005/06 and 2006/07 and for the Council performance in reducing DToC had significantly improved since April 2007.  Members were advised that the DToC rates in the Vale of Glamorgan for social care reasons between the period January to September 2007 were as follows:

 

            January             6

            February           3

            March               2

            April                  1

            May                   0

            June                  0

            July                    2

            August              4

            September       2

            Total               20

 

The report identified the main reasons for DToC in Cardiff and the Vale as being patient choice which accounted for approximately half of the cases, and health and social care reasons accounted for the next two most common reasons for delay.  Details of the figures for all of the reasons were attached at Appendix 3 to the report.  The report stated that in addition to the published Wales Audit Office report, key recommendations had been made specifically for both Cardiff and the Vale of Glamorgan Councils as detailed below :

 

 

Recommendations

Current Position

R1

“The Council should consider operating a dedicated hospital social work service responsible for all Vale of Glamorgan residents when they are in hospital.

Cardiff had moved to this model approximately 18 months ago, resulting in an increase in unallocated cases awaiting assessment.  The reconfiguration in Cardiff had not resulted in an improved service.  In the Vale a small dedicated hospital Social Work Team, covered Llandough, University Hospital Wales and Princess of Wales Hospital.  The team concentrate on assessments of new patients not known to Social Services.  The Community Social Work Teams pick up those already known to a Community Case manager and the hospital team provides a link with the wards.  Currently the Hospital Social Work Team provides dedicated Social Work cover to the wards with higher numbers of referrals and a Duty Social Worker covers other wards.  There is currently no waiting list for allocation of cases, as new referrals are dealt with as a priority.

R2

The Council should consider how best to increase the involvement of its housing service in the strategic planning and management of delayed transfers of care.

This issue is being addressed as an action in the Social Services Change Plan.

R3

The Council should consider if the current Contact Centre referral arrangements are as effective as possible in assisting communication with other agencies and the public.

This issue is being addressed as an action in the Social Services Change Plan, involving the co-location and proposed integration of the Adult Services Contact Centre (CIC) into Contact OneVale.

R4

The Council also needs to reconsider the more general communication difficulties between its officers and hospital staff.  It needs to document the problems and deal with each one by one.

Issues in relation to delays in evidenced Unified Assessment and eligibility criteria decision making are being addressed in partnership DToC meetings and the Timely Discharge Programme Board.

 

Members were advised that the actions arising from the recommendations would be incorporated into the Social Services Change Plan.  In discussing the Social Services Change Plan the officer advised that an update report would be presented to the Scrutiny Committee at its January meeting in 2008.  Members stated that they welcomed the report and wished to receive a copy of the full report which they considered would provide further detailed information in relation to the Vale.  The officer advised that the Vale Council part of the report was before Committee but that the LHB part was not for public consumption but they were requested to make enquiries with the LHB to request consideration that the report be released for Members of the Vale Council.  Should the request be granted a copy of the report or the all the decision of the LHB would be presented to the Scrutiny Committee in January 2008.

 

During discussion Members were also informed that the Change Plan would be updated but would not take into account Recommendation 1.  Officers had concerns in relation to the implementation of this recommendation due to the fact that the reconfiguration in Cardiff had not resulted in an improved service.  The four recommendations would be carefully considered and any reasons given with evidence should the Council consider that they should not be implemented at this stage.  Members requested that when all the amendments to the Change Plan had been made that they be highlighted in order that effective monitoring and scrutiny could take place.  Members questioned officers in relation to the strategies that were in place should a clients preferred choice of placement not be available.  The Welsh Assembly Government had established policy guidance in relation to freedom of choice and the Council and Local Health Board had recently drafted guidance which would encourage discharge planning from the time that the person was admitted to hospital in order that discussion regarding their choice be determined at an earlier stage and that it should be adhered to when considering placements.  Members also requested further information on the use of Occupational health therapists and it was agreed that the Occupational Therapist Task and Finish Group which had been established by the Committee earlier in the year commence as soon as possible.

 

Having considered the report the Scrutiny Committee made the following

 

RECOMMENDATIONS -

 

(1)               T H A T the Interim Director for Social Services update the Change Plan to include the recommendations contained within the WAO report and it be submitted to the Committee in January 2008.

 

(2)       T H A T the areas in the Change Plan which reflect the recommendations be highlighted for Members’ information.

 

(3)       T H A T the report be noted.

 

Reasons for recommendations

 

(1-3)    In order to progress implementation of the recommendations as set out within the report.

 

 

606     SECOND QUARTER PERFORMANCE: MONITORING CHILDREN AND FAMILY SERVICES (IDSS) -

 

The Operational Manager for Children and Family Services highlighted for the Committee the areas where performance had increased.  Members raised the following queries in relation to the performance report :

 

PI No

Answer

SCC16 - The percentage of the reviews of child in need plans carried out in accordance with the statutory timetable.

This was a new indicator with the information not being available electronically and the manual system not being reliable.

SCC19 - The percentage of children looked after at 31st March who were registered with a provider of general medical services at that date.

This was an annual figure and as such was not yet available although Members were reassured that at the initial assessment a child’s medical details were noted and the child is registered with an appropriate General practitioner.  It was envisaged that the use of the integrated Children’s Services system would enable all the information as detailed above to be available when required.

SCC8b and 9b - The average time taken to complete initial assessments that took longer than 7 working days to complete and the average time taken to complete those requiring core assessments that took longer than 35 days.

Due to the fact that there had been  some complex cases this had had  a significant impact on the figures although the process could be managed better in order for performance to improve.  The way information was recorded was not suitable for the purpose but the ICS system it was envisaged would assist and would also flag up where the Council was not meeting its targets in order for the services to be concentrated in that area.

SCC25 - The percentage of statutory visits to looked after children due in the year that took place in accordance with regulations.

There was a fixed number of visits and this entailed a visit in the first week of placement and not less than every six weeks thereafter. 

SCC23a - The percentage of children looked after who were permanently excluded from school during the school year.

The figure was to be reported annually although Members wanted reassurance that any child that was excluded was being identified early on in the process and the officer could advise that every school had a responsible person who would consult with the link co-ordinator in Social Services in order to identify when children were absent.  Mark Wheeler advised Committee that in most of the incidents performance had not dropped, it was that too high a target had been set.

 

RECOMMENDED –

 

(1)   T H A T  performance indicators that are collated on an annual basis be only reported annually. 

 

(2)   T H A T the report be noted.

 

Reasons for recommendations

 

(1)       In order that printing costs can be reduced and that effective monitoring can take place on the relevant performance indicators.

 

(2)       To acknowledge the progress that has already been made to date.

 

 

607     MANAGEMENT INFORMATION REPORT: CHILDREN AND FAMILY SERVICES (IDSS) -

 

The report was presented for Member’s information and / or consideration.

 

RECOMMENDED - T H A T the report be noted.

 

Reason for recommendation

 

To apprise Members.

 

 

608     SECOND QUARTER PERFORMANCE MONITORING: COMMUNITY CARE AND HEALTH (IDSS) -

 

The Operational Manager advised the Committee of the areas where the Service had improved which was recognised via the traffic light system of recording. The report also highlighted the changes in respect of delayed transfers of care and that if DToC was meeting its targets there would also be a knock-on effect to other service areas and the challenges facing the department were therefore a balancing act.  Members noted that with the introduction of the Ffynnon Management Information system it would be “quicker and smarter” for Members to be able to monitor service areas on a regular basis and that only the key areas where performance was either on target, under achieving or enhanced would be presented for Members’ consideration.

 

RECOMMENDED - T H A T the performance monitoring report be noted.

 

 

609     MANAGEMENT INFORMATION REPORT: ADULT SERVICES (IDSS) -

 

Members welcomed the report in the format presented and considered that it was a clearer and concise format for providing Members with the information required.

 

RECOMMENDED - T H A T the report be noted.

 

 

610     SECOND QUARTER PERFORMANCE MONITORING: STRATEGY PERFORMANCE MANAGEMENT AND COMMISSIONING (IDSS) -

 

There were no national performance indicators for the Service set by WAG.  Members however requested whether it would be possible to consider further local PIs which would seek to consider strategy processes and training issues and requested that the officer consider comparisons with other local authorities that could be used to measure performance.  It was however noted that there were a number of PIs that the Service could utilise albeit they were cross-cutting issues and they could be found in other service areas’ performance indicators. 

 

RECOMMENDED -

 

(1)       T H A T congratulations be forwarded to the officers in respect of the green status in the performance indicators in the report.

 

(2)       T H A T officers be requested to make comparisons with other local authorities and consider further PIs for the Service that could be agreed by the Scrutiny Committee.

 

 

611     SECOND QUARTER PERFORMANCE MONITORING: PUBLIC HOUSING (DLPPHS) -

 

In considering the performance indicators, Members noted the success of some of the schemes for example Homes 4U.  

 

Question

Answer

HLS8b - Members raised concern in relation to the vacant property.

The department was considering a handyman type service to assist with various repairs within properties.

How is the Authority progressing with the homeless leasing scheme?

Officers had recently met with a Housing association, however due to changes in the Welsh Assembly Government subsidy from April 2008 the subsidy regulations would change which would make leasing an issue for any person not able to claim full benefit.  As a result of discussions with Haffod Housing it was likely that four properties would be available for leasing in 2008.

HLS9a, b and PA26 - These related to the turnaround of properties and Members requested whether the turnaround figure could be further reduced which would benefit all immensely.

This was a significant issue for the department in relation to major repairs and the department was currently working with the building maintenance section in respect of trying to introduce a programme for improvement which would be more stringent. There was a need to work with the building maintenance team and for them to fully understood that housing was a priority.  It was a challenge to the service but all officers were fully committed to ensuring that the minor and major repairs were undertaken as a matter of urgency.  Members noted the work that had been undertaken in relation to tenants and that the department was leading on a tenant driven approach to dealing with the issues.

Do we have any idea what the turnaround time for voids is within other housing associations?

In general the turnaround time was significantly higher than the Local Authority  i.e. one week.

HHA2 - Average number of working days between homeless presentation and discharge of duty for households found to be statutory homeless.

The Council was not meeting its target but this was due to a number of reasons, lack of accommodation and client choice.

 

RECOMMENDED - T H A T Mr. Mike Ingram and his department be congratulated in respect of the number of performance indicators on target or above.

 

 

612     SECOND QUARTER PERFORMANCE MONITORING: PRIVATE SECTOR HOUSING AND COMMUNITY SAFETY (DPPHS) -

 

It was noted that the report had a number of local indicators with only five national indicators.  In relation to the Inspection of Houses in multiple occupation local indicator, Members were advised that the target would be reviewed by the third quarter. Members were also advised that the mandatory houses in multiple occupation licensing scheme had commenced and related to around 30 premises in the Vale. Members considered the overall reduction in the crime statistics and were reassured that the Safer Vale Partnership had introduced a number of positive initiatives such as the alley gates scheme which had assisted with the reduction of crime and again congratulated the officers on the performance targets that had been met or had been greater than the target.

 

RECOMMENDED - T H A T the report be noted and officers be congratulated on the targets that had been met.