HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE
Minutes of a meeting held on 12th September, 2016.
Present: Councillor R.L. Traherne (Chairman); Councillor Dr. I.J. Johnson (Vice-Chairman); Councillors Ms. R.F. Birch, S.C. Egan, E. Hacker, J.W. Thomas, S.T. Wiliam and Mrs. M.R. Wilkinson.
309 APOLOGIES FOR ABSENCE –
These were received from Councillors R.J. Bertin and H.C. Hamilton.
310 MINUTES –
RECOMMENDED – T H A T the minutes of the meeting held on 18th July, 2016 be approved as a correct record.
311 DECLARATIONS OF INTEREST –
No declarations were received.
312 PRESENTATION – INTRODUCTION TO LEISURE SERVICES –
The Operational Manager for Leisure conducted the presentation which provided an overview of the services provided by the Council’s Leisure Team and outlined some of the key challenges facing each individual service area.
In referring to the strengths in relation to Parks and Ground Maintenance, the Operational Manager outlined that in the Vale, seven parks had been awarded Green Flag status and in total this meant that the Vale was the third highest ranking Authority in Wales. A wide range of functions was also provided by this team, which included the following:
- Grass cutting
- Tree management
- Fine turf
- Sports pitches
- Playgrounds – of which there were over 100 in the Vale of Glamorgan
- Feature parks
- Allotments
- Public open spaces
- Jenner Park.
In addition, the Parks and Ground Maintenance Team would also support public events such as litter picking. Other strengths outlined by the Operational Manager included a highly trained, experienced workforce and the ability to provide services to other departments such as Education, Housing, Social Services and Planning and also a customer focused approach.
With regard to future challenges facing the Parks and Maintenance Team, these included the following:
- reshaping of services
- an ageing workforce
- a gap in the number of apprentices
- Community Asset Transfers and the need to question the future use of some facilities
- fees and charges / subsidy required for some facilities. This may require the need for a more fundamental approach to the way that fees and charges were calculated
- capital investment which related to the requirement to invest in a number of buildings, particularly to ensure Green Flag status.
In terms of Leisure Centres, the Operational Manager highlighted that the ten year contract with Legacy Leisure was providing certainty on price and service delivery quality and a Wales Audit Office report published in 2015 stated that the provision of the Vale Leisure Centres was the most cost effective provision in Wales. He advised that the Centres contained modern, attractive facilities with multi gym equipment which, for customers, represented a strong attraction and there was also a strong sense of customer loyalty.
The main challenges Leisure Centres included the need to modernise changing facilities at the main sites such as Barry and Penarth. The Operational Manager stated that some of the changing rooms were 30 years old and so it was hoped that the investment in new facilities would increase attendance. There would also be challenges around the contract extension, variations such as the new standards around the provision of the Welsh language and the development of new facilities including a new 3G pitch in Colcot. In addition, contract monitoring and customer usage data were seen as areas of development. Two other significant challenges were the need for future investment in buildings and the possible consideration of new build facilities. Finally, the re-tendering of the contract around the provision of leisure services, although a number of years away, was something that needed to be undertaken.
For Sport and Play, the Operational Manager advised that this was a highly valued service by customers, which had a highly motivated, experience workforce and also a history of successful partnership working. Results from the Sport Wales Survey had ranked the Vale at a high position in terms of the number of children and adults participating in physical activity. Future challenges around Sport and Play related to the dependence on external funding and outcomes of the Sport Wales Community Sport review.
In referring to the way that Community Centres operated in the Vale, the Committee was advised that there were 22 Centres in total. These Centres were run and staffed by volunteers and they provided a wide variety of activities with many types of groups using them. The Centres would also be available for one off bookings and were highly valued by local residents. Furthermore, the Operational Manager outlined that there was an efficient operating model in place that empowered local communities to operate their own facilities. This was a model that was being copied by other Local Authorities in Wales. Future challenges around Community Centres related to the recruitment of volunteers and the maintenance and age of buildings.
In reply to the question as to whether the programme to improve and update changing rooms would include facilities at Pencoedtre Field in Barry, the Operational Manager referred to the difficult situation for the Council in deciding whether or not to invest in facilities that were used infrequently.
A Committee Member queried the role of Public Health Wales and the work being undertaken with the Council’s partner organisations. In response, the Operational Manager stated that this was crucial and that the Council worked effectively with all partners and he cited the example of the exercise referral scheme which had been used successfully in partnership with local doctors’ surgeries. He also stated that there was more that the Council could be doing and he referred to the importance of early learning activity being undertaken in partnership with Health in order to raise awareness of improved diet and physical exercise.
The Chairman asked if an update could be provided in relation to the Reshaping Services Project and objectives for Parks and Ground Maintenance. In reply, the Operational Manager advised that it was still too early for definitive comments but plans would be emerging over the next few weeks.
RECOMMENDED – T H A T the contents of the report be noted.
Reason for recommendation
In order to provide an overview of the services provided by Leisure to both residents and visitors to the Vale of Glamorgan.
313 REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL TO 31ST JULY, 2016 (DSS) –
The Operational Manager for Accountancy presented the report, the purpose of which was to advise Members of the position in respect of revenue and capital expenditure for the period 1st April to 31st July, 2016 regarding those revenue and capital budgets which formed the Committee’s remit.
Council, on 2nd March, 2016 (minute nos. 885 and 884 respectively) approved the Revenue and Capital Budgets for 2016/17. Reports monitoring expenditure are brought to this Committee on a regular basis.
In setting the Social Services budget for 2016/17, the use of £970,000 from the Social Services Fund was approved.
It was currently projected that the Social Services budget would outturn with an adverse variance of around £1m.
A table and graph setting out the variance between profiled budget and actual expenditure to date and the projected position at year end were attached at Appendix 1 to the report.
Children and Young People Services – The major issue concerning this service for the coming year would be the continued pressure on the children’s placements budget. Work continued to ensure that children were placed in the most appropriate and cost effective placements. However, it should be noted that due to the potential high cost of each placement, the outturn position could fluctuate with a change in the number of Looked After Children. This budget would be closely monitored during the year.
Adult Services – It was projected that the Community Care Package budget could outturn with a variance of up to £1m by year end. This budget was extremely volatile and had been adversely affected this year by the increase in the cost of packages commissioned as a result of the introduction of the National Living Wage, the continued pressure of the budget from demographic growth and clients having increasingly complex needs. The final outturn was, however, difficult to predict. Final negotiations regarding fee levels were being concluded with service providers but proposed increases were already above the level of inflation provided for within the budget.
The annual deferred income budget for 2016/17 had been set at £747,000 and, as at 31st July, 2016, income received to date was £145,000 over-recovered. It was currently being projected that this budget would outturn at £100,000 under budget by year-end and this favourable variance was included as part of the projected overspend for care packages.
The service would strive to manage growing demand and try to mitigate this position and some initiatives may be funded via regional grants in the current financial year. It was proposed that up to £1m be used this year from the Social Services Legislative Changes fund to cover the shortfall. Committee would be provided with further details during the course of the year.
Leisure Services – There was currently an adverse variance of £41,000 to the profiled budgets as a result of high repair costs for vehicles during the start of the Grounds Maintenance season. It was however anticipated that this would reduce over the winter months and therefore it was currently projected that the overall budget would outturn on target.
Appendix 2 to the report showed the projected outturn this year for the savings targets for this Committee.
Within Adult Services, £100,000 of the full year saving generated from the Hafod Homes transfer had been offset against the £300,000 saving for Residential Services. Currently, there were no other approved plans in place to find the remaining £200,000 of this saving. Further consideration would have to be given to the way in which the saving can be fully achieved during the year. With regard to the Care Package Budget Reduction, while there was significant pressure on this budget, schemes had been put in place to deliver savings in this area by transferring domiciliary care clients to direct payments, by putting in place additional reablement capacity and by establishing a review team.
In relation to the Social Services Programme, the Directorate was currently required to find savings totalling £2.257m by the end of 2019/20 and this target was analysed by year in the following table. The surplus shown and the savings brought forward figures were as a result of the foster carer recruitment project, which was being developed in addition to the required savings targets. This surplus could be used to mitigate any increase in savings to be found in future years.
|
Year
|
Savings Required
£000
|
Savings Identified
£000
|
In Year Surplus/ (Shortfall)
£000
|
Cumulative Surplus/ (Shortfall)
£000
|
|
Savings Brought Forward
|
|
110
|
110
|
110
|
|
2016/17
|
1,002
|
1,078
|
76
|
186
|
|
2017/18
|
605
|
605
|
0
|
186
|
|
2018/19
|
320
|
320
|
0
|
186
|
|
2019/20
|
330
|
330
|
0
|
186
|
|
TOTAL
|
2,257
|
2,443
|
|
|
Appendix 3 provided an update on the individual areas of saving within the Social Services Budget Programme.
In order to respond to the level of savings required as a result of the projected reductions in funding from Welsh Government, the Council had instigated its Reshaping Services change programme. Cabinet acknowledged that the Social Services Directorate already had two major initiatives underway – the Collaborative Working Programme and the Budget Programme. These programmes already contained projects which were progressing the opportunities identified as part of the Reshaping Services Programme. Included in Appendix 3, the Reshaping Services logo had been shown against specific projects which had a specific alignment with the objectives of the Reshaping Services strategy. The whole of the Social Services Budget Programme reported into the Reshaping Services governance arrangements.
With regard to capital expenditure, Appendix 4 detailed the financial progress on the Capital Programme as at 31st July, 2016.
A new capital scheme to the value of £219,000 had been approved from the Intermediate Care Fund (ICF) for two “step-down” units at Longmeadow Court. It had been requested that the Capital Programme be increased accordingly.
For Parks and Grounds Asset Renewal, the Visible Services Asset Renewal budget had been agreed by Cabinet on 22nd February, 2016, Minute No. C3080. Recommendation 3 stated “That delegated authority be granted to the Managing Director and the Head of Finance, in consultation with the Cabinet Member responsible for Finance, to make additions, deletions or transfers to or from the 2016/17 to 2020/21 Asset Renewal budgets as appropriate”. This delegated authority had been used to allocate the budget and £150,000 had been allocated to Parks and Grounds Maintenance.
In terms of Asset Renewal, it had been requested that £50,000 be transferred from the Visible Services Reserve in order to fund works at the Salisbury Road Play Area, which was in line with the project brief and community expectations. This funding was set aside as part of the closing report in 2015/16. In addition, delegated authority had been used to apportion a further £20,000 for this scheme from the Barry Regeneration Project Development Fund as well as allocating £1,000 for the Alexandra Gardens Play Area.
Appendix 5 provided non-financial information on capital construction schemes. From this Appendix, it was reported that most of the previous year’s schemes had now commenced and some were complete. Start dates had also been provided for new schemes for this financial year and these would be monitored closely to identify if capital schemes began to slip and to identify if further action needed to be taken.
A Committee Member asked for further clarification around the projected £1m budget shortfall for Community Care Packages. In reply, the Operational Manager stated this related to challenges highlighted at previous Committee meetings, such as the National Living Wage, increased demand for services and the financial cap on the weekly charge for domiciliary care services.
The Chairman noted that building works for a number of capital projects had yet to commence and he queried progress around these. In reply, the Head of Adult Services stated that he would need to clarify the progress in relation to Rhoose Road, while works at Cartref Porthceri, to address subsidence, would be completed by the end of the financial year.
In reply to a query relating to the progress made for capital projects within Leisure Services, the Operational Manager for Leisure stated that the information presented was correct up to 31st July, 2016 and so the actual spend to date would be greater to that shown in the report.
In answer to a question around progress on savings targets within Adult Services, the Head of Adult Services stated that within the area of care packages, savings had been made following input from the review team, but it was a challenge to meet targets where demand for services was increasing. With regard to residential services, he advised Members that savings would be progressed through the Reshaping Services programme, although he stated that it would be a challenge to achieve the remaining £200,000 budget savings. In terms of the other Reshaping Services projects, the status of these were red because individual projects had not been identified around which further work was still ongoing.
RECOMMENDED –
(1) T H A T the position with regard to the 2015/16 revenue and capital monitoring be noted.
(2) T H A T the progress made in delivering the Social Services Budget Programme be noted and be referred to Cabinet for its consideration.
Reasons for recommendations
(1) That Members are aware of the position with regard to the 2016/17 revenue and capital monitoring relevant to this Scrutiny Committee.
(2) That Members are aware of the progress made to date on the Social Services Budget Programme.
314 THE VALE OF GLAMORGAN AND CARDIFF INTEGRATED FAMILY SUPPORT SERVICE ANNUAL REPORT 2015/16 (DSS) –
The purpose of the report was to ensure that Elected Members had considered the 2015/16 Annual Report for the Vale of Glamorgan and Cardiff Integrated Family Support Service (IFSS).
Through provision of its Flying Start, Families First and IFSS programmes, the Council had in place a coherent framework for delivering the range of preventative, protective and remedial family support initiatives set out in relevant Welsh Government strategies. By providing intensive and specialist help to families where risks were escalating, the IFSS had a key role to perform in reducing harm to children and also the volume of avoidable admissions to the Looked After Children service.
The IFSS programme intends to provide more holistic support to families by breaking down boundaries between Local Government and Health, between Adult Services and Children’s Services.
In accordance with very detailed regulations which prescribe the way in which an IFSS must operate, the Vale of Glamorgan and Cardiff Councils’ and the Cardiff and Vale University Health Board established a Management Board chaired by the Director of Social Services for the Vale of Glamorgan. The Management Board was supported by an Operational Steering Group which was responsible for overseeing implementation and development during the first year of operation. In order to resolve any operational issues and to provide closer monitoring of the service, an Operational Group was to be reinstated in 2016/17. Cardiff Council had agreed to undertake direct management of the service.
The IFSS was based at the Alps and it had been operational since the end of February 2012. The service had five principle functions:
- Undertaking intensive direct work with families through the application of time-limited, family focused interventions;
- Providing advice and consultancy to practitioners and agencies on engaging complex families with parental substance misuse;
- Working jointly with the case managers and others to ensure that the family can gain access to the services they need;
- Spot-purchasing services not otherwise available; and
- Providing training on evidence-based interventions for the wider workforce.
The Committee was also advised that in 2015/16, funding for the IFSS had been transferred into the Revenue Support Grant and allocated equally between the two local authorities; £280,000 for Cardiff and £280,000 for the Vale of Glamorgan. Cardiff would be responsible for administering the joint service with the Vale of Glamorgan being recharged for its proportion of the running costs.
Section 64 of the Children and Families (Wales) Measure 2010 required an annual report on the effectiveness of the IFSS to be submitted to Welsh Government. The latest report for 2015/16 was attached at Appendix 1.
The Annual Report outlined that the IFSS was meeting expectations in terms of numbers of referrals and the outcomes achieved. It also outlined the robust system of data collection and analysis in place to demonstrate how families were referred and prioritised for support and the impact upon key areas of wellbeing such as education, parenting, relationships, alcohol or drug cessation. The results demonstrated that the IFSS was taking a lead role in strengthening services to support some of the most disadvantaged children, those who were in need or at risk because of parental alcohol or drug dependence.
The IFSS aimed to receive at least 84 referrals during the year and planned to work with 70 families in 2015/16. They exceeded this by receiving 137 referrals and working with 93 families; 71 in Cardiff and 22 in the Vale of Glamorgan. This was a significant increase compared to the previous year where IFSS worked with 36 families, 26 in Cardiff and 10 in the Vale of Glamorgan. It was outlined that the Vale of Glamorgan was keen to see the figures rise further for this Local Authority area, particularly given that the funding for the service was divided equally. Discussions had taken place between Cardiff and the Vale of Glamorgan to agree this principle and monitoring would continue via the Operational Group. In an attempt to increase the number of referrals from the Vale of Glamorgan, an IFSS worker was based in the Docks Office one day a week to be available for consultations with Social Workers. In addition, the Operational Manager met with the IFSS Team Manager on a monthly basis to monitor referrals and allocations.
The report advised that the main priorities for the year ahead included increasing the number of referrals worked with by intervention specialists. Priority would also be given to training the wider workforce in the IFSS model, including housing associations and their housing support teams. At a local level, there were plans to strengthen the maintenance phase that followed IFSS intensive intervention and to embed the system for formal review of cases. In addition, the IFSS Board would continue to plan the structure and pattern of future service delivery and identify funding for the medium to long term.
The Chairman queried the monitoring systems in place for those families that no longer received intensive support. In reply, the Operational Manager from the City of Cardiff Council stated that robust monitoring was in place which occurred on a number of levels. At the end of the intensive support programme, maintenance meetings would be arranged with input from independent reviewing officers. The IFSS support staff were all appropriately trained and the service would revisit each case at three, six and twelve monthly intervals in order to measure how well families had achieved their goals. Furthermore, she added that overall the service could confidently say that most families did not experience the same challenges after support was provided and 80% of families felt confident of achieving goals. If there was a requirement, the IFSS would go back to provide additional support to families and to review the goals that had been set out. The main aim of the IFSS was to achieve better family functions in order to improve how children were looked after. The IFSS used the Warwick and Edinburgh scale to measure happiness and the IFSS was able to effectively identify those aspects which helped families to achieve their goals.
A Committee Member, in referring to the 50:50 budget split between Cardiff and the Vale Councils, the number of families referred from the Vale and the number of no space referrals, queried whether the Council was receiving value for money. In reply, the Committee was advised that the IFSS was working closely with the Vale’s Children and Young People Services. The IFSS was extending the referral criteria in order to support a greater number of families, and it had been agreed that each Intervention Specialist in the IFSS would now take two families from the Vale at any one time. Whilst the model of IFSS has been based on crisis intervention, i.e. intervening most effectively at the point of crisis, the need to reduce the instances of ‘no space’ being available has been acknowledged and is being addressed through efforts to increase capacity.
A Committee Member stated that with regard to the change in funding, it should be recognised that there was a 70:30 split and that Cardiff was bigger, but given that the funding was equal, there was a need to ensure that the Vale’s money was spent in the Vale. The key question was how this would be achieved. In reply, the Director stated that he accepted the Committee’s concern but he made the point that the current budget settlement, which apportioned funding into the Revenue Support Grant, was for 2015/16 and this could change in 2016/17.
RECOMMENDED –
(1) T H A T the contents of the Integrated Family Support Service Annual Report for 2015/16 be noted.
(2) T H A T the work being undertaken to provide intensive support to families, especially those where children are adversely affected by parental alcohol or drug dependence, be endorsed.
Reason for recommendations
(1&2) To ensure that the Council’s statutory functions in relation to providing integrated family support services are fully met in accordance with Welsh Government guidance.
315 RESHAPING SERVICES – REVIEW OF RESPITE CARE FOR ADULTS WITH LEARNING DISABILITIES (REF) –
On 25th July, 2015, Cabinet received a report which sought approval for the undertaking of a review of the Council’s residential respite care services for adults with learning disabilities, including a programme of consultation on the way that services were delivered.
The report advised that the Vale of Glamorgan Council offered respite care to approximately 82 adults with learning disabilities and their carers in order to meet their presenting needs. On average service users had approximately 28 days respite service per year, which was used by them over a number of occasions.
Historically, the respite care needs of adults with learning disabilities in the Vale were met through the use of both the Council’s Respite Residential Care facility, based at Rhoose Road, and the spot purchasing of residential home placements where required.
More recently, it had been recognised that there was a demand by service users and their families for increased flexibility in the way that respite care was provided. People had chosen to either have this delivered through direct payments, the Council’s Adult Placement Service or through continued use of Rhoose Road. The spot purchasing of residential home placements for respite use by clients had reduced to single figures.
As part of the Reshaping Services Programme, all areas of Adult Social Services were being reviewed. As part of the first set of service reviews, Respite Care for adults with learning disabilities had been included in this work and a savings target had been assigned. This target had initially been set at £60,000 for the 2017/18 financial year.
The report advised that the demand for Rhoose Road had decreased in recent years which had impacted on the unit cost per occupying night at this facility. In 2015/16 the average unit cost per occupied night was approximately £391 (gross) and £343 (net of income). If the facility had been at full capacity the average unit cost per night would have been reduced to £301 (gross) and £265 (net of income).
In terms of future needs, an analysis had been carried out to ascertain the number of young people with complex needs who were currently not known to Respite Care Services but who would possibly require respite care in the future. Current data showed that there were on average three or four people transitioning into the service each year who would require overnight respite care. Some of these people received funding from the Health Board and others would access the Long Term Care service in due course, due to physical disabilities. In each year, approximately eight service users would exit the service.
It was therefore proposed to offer an alternative to the respite care provision that was offered at Rhoose Road in order to better meet presented needs. This would be achieved in two ways. Consultation with users of Rhoose Road and their families would therefore be on the basis of two elements.
Consultation Element 1 – where an assessment showed that respite care services should be provided and services users chose not to receive direct payments, the Vale of Glamorgan’s Adult Placement Service would be offered to people and their carers as a default option. This service currently had capacity to hose additional placements and offered greater flexibility and opportunities to people and their carers. 24 of the 36 listed users of Rhoose Road could have all their respite care needs met by the Adult Placement Service. Eight of these people access Rhoose Road and the other 16 could access the Adult Placement Service. The service had the capacity to accommodate this level of growth as it currently stood.
Consultation Element 2 – for those who had particularly high level care needs (12 of the 36 current users of Rhoose Road) who had been assessed as requiring residential respite provision, the Council’s Adult Placement Service would not be suitable and it was proposed that the Council would look to provide the required 24 hour high level of support to meet the needs of this client group through an external provider.
The Chairman, in querying the future use of Rhoose Road, was advised that there were a number of aspects to consider, including how the use of the service had changed and that new opportunities for service users existed, such as Direct Payments and the Adult Placement Service. Both these areas had grown and had left the Council with a situation in which the Vale was struggling to make best use of the facility. At present, the proposal was for consultation to begin as the Council was keen to learn the views of the service users.
A Committee Member queried whether the reduction in the number of nights, reported during 2015, represented an actual trend or if this drop could be explained by other factors. The Member asked for a further analysis to be undertaken and he also requested more information in relation to the Adult Placement service. The Committee noted that any proposals would have to be clearly set out and that these would form the part of any future business case.
In reply to a question relating to Direct Payments and whether there was enough domiciliary care provision, the Head of Adult Services stated that the use of Direct Payments may enable the service to access carers or personal assistants, who in many cases would already be known to the individual.
The Committee queried the timescales around the consultation exercise. In reply, the Head of Adult Services stated that the timetable could be achieved but any business case could not be written without consultation being undertaken. He added that throughout last year there were 36 individuals that utilised the service at Rhoose Road. These individuals were well known and the Council was already working with them.
The Committee was in agreement that a site visit to Rhoose Road would be arranged after the consultation with services users had been completed.
RECOMMENDED – T H A T the decision to undertake a review of the Council’s residential care service for adults with learning disabilities, including a programme of consultation on the way services are delivered, be endorsed.
Reason for recommendation
To enable a consultation exercise to be undertaken with service users and their families to inform proposals as to how the Council can best meet relevant respite care needs.
316 SERVICE USER AND CARER CONSULTATION – 2015 OUTCOMES AND 2016 PLANS (DSS) –
The Interim Head of Service, Business Management and Innovation, presented the report, the purpose of which was to provide an overview of the ongoing service user and carer engagement activity within Social Services.
On an annual basis, the Policy and Quality Assurance Officer for Social Services would undertake a programme of consultation to explore the experiences and views of service users and their families. The theme of the consultation would be underpinned by service priorities as confirmed by senior management at the start of the financial year. These priorities were derived from findings from audit, inspection and other quality assurance processes. A three year consultation plan was developed with Operational Managers and Heads of Service and it allowed sufficient flexibility to respond to emerging needs.
During 2015/16 the Director consulted on the levels of satisfaction with support and information received while receiving the following services:
- Adoption Service: Satisfaction with processes and support surrounding recruitment, training, matching, placement and review within the adoption process;
- Advocacy for Children and Young People;
- Flying Start;
- Protection of Vulnerable Adults;
- Respite for Adults with a Learning Disability;
- Youth Offending Service: Management Board;
- Contact One Vale: Effectiveness of the signposting and information provided by C1V. This was part of a rolling programme and new service users were identified each month;
- Adult Placement Service: satisfaction with the referral process, matching, and placement;
- Meals on Wheels: satisfaction with information provision, timing of meals, and staff;
- Residential Services: Satisfaction with moving into the residential home, the living arrangements and the general management within the residential service.
Contained within paragraph 10 of the report was an overview of the 2015/16 thematic learning undertaken. Paragraph 11 contained a summary of what the Directorate had learned relating to good practice identified alongside any actions for improvements.
The report advised that consultation with citizens would run on a three year priority plan, which had recently been updated to incorporate new requirements 2016-18. This was attached at Appendix 1. In 2016, the introduction of the Social Services and Well-being (Wales) Act meant that the Directorate would be carrying out additional consultation activity to respond to requirements from Welsh Government. Predetermined questionnaires would be sent to a sample of adult social care services users with a care and support plan and all children who were involved with Social Services to obtain satisfaction levels with their involvement.
Members were advised that the Directorate would continue to identify key areas to carry out specific consultation projects to support the existing process and the priorities for consultation would continue to be reviewed annually. All services that were registered and inspected would therefore remain a priority in addition to the qualitative measures required by the Act.
Having considered the report, the Committee
RECOMMENDED –
(1) T H A T the Service User and Carer Consultation Report be noted.
(2) T H A T the Committee continues to receive information about the annual programme of consultation activity.
Reasons for recommendations
(1) To provide Elected Members with information about engagement and consultation activity with service users and carers.
(2) To ensure effective scrutiny of a key function undertaken by Social Services on behalf of the Council.
317 REPRESENTATIONS, COMPLAINTS AND COMPLIMENTS (DSS) –
In presenting the report, the Interim Head of Business Management and Innovation advised that the purpose was to advise Members of activities, performance and achievements within this area of work for 2015/16 and to outline improvements planned for 2016/17.
The report advised that the handling of complaints was a crucial part of the responsibilities undertaken by Social Services. An effective and properly managed complaints and compliments system played a key role in ensuring that users received the services to which they were entitled.
The Directorate had sought to ensure that its systems for managing complaints were robust. Effective monitoring of complaints provided a valuable source of feedback, highlighting aspects of service delivery which fell below the standard the Council aimed to achieve. Handling complaints promptly, efficiently and responsively enhanced the Directorate’s reputation with all its stakeholders.
This was the second year since the revised complaints guidance from Welsh Government had been operated. The guidance supported implementation of the Social Services Complaints Procedure (Wales) Regulations 2014 and the Representations Procedure (Wales) Regulations 2014.
The Annual Social Services Representations and Complaints Annual Report 2015/16 was attached at Appendix 1. The Directorate received 87 concerns or complaints in 2015/16 with a breakdown across the service as follows:
|
|
Enquiries *
|
Complaints
|
|
Adult Services
|
18
|
26
|
|
Children and Young People Services
|
20
|
23
|
|
Business Management and Innovation
|
0
|
0
|
|
Total
|
38
|
49
|
* An enquiry is an issue of concern to the service user, dealt with by the team, without escalation to a complaint.
The information showed a small increase in the number of enquiries (34 in 2014/15), and a small decrease in the number of complaints (55 in 2014/15).
The Public Services Ombudsman for Wales (the Ombudsman) provided an external independent service for the purpose of considering complaints made by members of the public in relation to all Local Authority services, including Social Services. During 2015/16, the Ombudsman received four cases involving Social Services in the Vale of Glamorgan. Two of these complaints were not investigated by the Ombudsman and two were investigated but had not been completed by the end of March 2016. However, both have now resulted in voluntary settlements, one was concluded and the other matter was near completion.
The Social Services Procedure included timescales within which complainants should have received a response to their complaint. During 2015/16, there was a reduction in performance, with 24% not having met prescribed timescales. This was a significant increase on the 6% in 2014/15. A number of reasons contributed to this figure, including the complexity of complaints and a change in the way the figures were collated.
The most common complaints received were as follows:
|
2015/2016 – Most Common Complaints Recieved
|
Adult
Services
|
Children and Young People Services
|
Business Management and Innovation
|
|
Charges for Services
|
3
|
0
|
0
|
|
Denied a Service
|
0
|
3
|
0
|
|
Lack of response from a team
|
0
|
3
|
0
|
|
Quality / level of service
|
9
|
10
|
0
|
|
Placement provision
|
1
|
0
|
0
|
|
Policy dispute
|
2
|
0
|
0
|
|
Ongoing concerns
|
1
|
0
|
0
|
|
Complaint about staff
|
4
|
5
|
0
|
|
Unhappy about care provision
|
4
|
0
|
0
|
|
Other
|
1
|
5
|
0
|
|
Total
|
26
|
23
|
0
|
Compliments were also regarded as important information and used to identify good practice. The Directorate received 28 compliments during 2015/2016, compared to 76 in 2014/15. Details were included in the Annual Report.
The Chairman, in referring to page 19 and the lessons learnt, asked whether officers were satisfied that these lessons would be taken on board. In reply, the Director advised that the Service would ensure that the main aspects of the report would be considered at all team meetings and that team plans would include the relevant actions for improvement.
A Committee Member queried what the most common type of complaint was. In reply, the Interim Head of Business Management and Innovation advised that charging was a key theme and related to some very complex cases within Adult Services. The Committee was also advised that there was a varied picture and that issues raised in relation to Children’s Services were around the use of authority and control procedures that usually contained a degree of conflict with families.
RECOMMENDED –
(1) T H A T the Social Services Representations, Complaints and Compliments Annual Report 2015/16 be noted.
(2) T H A T the Scrutiny Committee continue to receive an Annual Report in relation to complaints and compliments received by the Social Services Directorate.
Reason for recommendations
(1&2) To ensure effective scrutiny of performance in Social Services and to provide evidence about the effect upon the lives of individual services users and their carers.
318 ANNUAL REPORT OF THE DIRECTOR OF SOCIAL SERVICES 2015-2016 – CHALLENGE VERSION (DSS) –
The Director of Social Services presented a copy of his Annual Report for 2015/16. He advised that, through an earlier workshop, Members of the Committee had had the opportunity to have dialogue with officers, to raise issues and recommend change. He stated his appreciation for the level of discussion and he thanked Members for their contribution.
The Annual Report that was attached at Appendix 1 gave the Director an opportunity to provide people in the Vale with a rounded picture of Social Services - based on evidence drawn from a wide range of sources such as what users and carers have said, key performance indicators and measurements of progress against the overall goals of the Council.
The Report was written for a wide range of people, including service users and carers but also Elected Members, the Council’s own staff, and a range of partners and providers who helped deliver services. It was used by the Care and Social Services Inspectorate for Wales (CSSIW) as evidence for their annual evaluation of the Council and to guide their inspection programme in the Vale of Glamorgan.
The Director’s Annual Report was important for the people of the Vale of Glamorgan, Members of the Council and partners, both statutory and in other service sectors. It outlined the current context within which Social Services were operating and detailed proposed priorities for improvement. Circulating the Challenge Version was intended to allow key stakeholders the opportunity to comment and make observations before the Report was finalised, ensuring that it accurately reflected the position of Social Services.
In outlining the format of the Annual Report, the Director advised that a key use made of it was to encourage greater ‘co-production’ in areas such as service design and operational delivery. This had to be grounded in an informed understanding of the overall issues and the way in which specific services were being delivered. It was important for readers to fully understand what was going on. Some people would be interested in the big picture and some only in the specific service they received. Page 5 of the report included a summary, whilst the overview from page 6 provided a focus on achievements. A major element of the Annual report was the ongoing challenges facing social services, and the Director highlighted the following:
- Managing reductions in funding while minimising wherever possible the impact on front line service delivery;
- Providing effective support for a rising population of older people with increasing levels of need, for children and other people with increasing complex health conditions and for families experiencing periods of difficulty and vulnerability;
- Developing closer partnership working in order to deliver new models of care and support services across the whole range of need;
- Meeting new service requirements with limited public resources available to implement the changes, including those arising from increased statutory obligations;
- Ensuring quality of care, managing risk of service failure and increased safeguarding responsibilities;
- Reducing unnecessary bureaucracy so that the Directorate gets help to people more quickly and provides staff with more time for direct work.
The Director added that the Vale Council had a good reputation for managing its budget. However, he alluded to challenges as a result of increasing demand for domiciliary care services and the case for extra resources. He also referred to the considerable programme in regard to the re-modelling of services and the expectations that the Council could eventually have to face unpalatable choices around how services were delivered, if budget pressures and savings continue to grow. He also mentioned similar challenges facing the local health board, which might result in the lowering of performance targets or a cap on staffing levels/use of agency staff. It was important, therefore, for any priority objective to address these strategic concerns and the Director made reference to the ‘agenda for change’ around which the Vale Council had a good track record.
As in previous years, each Head of Service in the Directorate had also provided an Annual Report, including an assessment of how well each Division was doing in different service areas and priority objectives for improvement in 2015/16. These were attached at Appendices 2, 3 and 4. They were to be published separately but at the same time as the Director’s Report. All the reports represented the views of the Director and other managers in Social Services; however, they were not Council policy at this stage.
The priority objectives contained in the reports would be delivered within the financial constraints set by the Social Services Budget Programme, which was approved by Cabinet and reported regularly. The final reports would be presented to Cabinet for approval of the priority objectives and then circulated widely. They would be made available via the Council’s website.
A Committee Member thanked the Director for a very detailed report. He commented on the assessment of challenges, and he highlighted his concerns around the financial situation and the projected £1million overspend for this year. He stated that with increased demand and fewer resources, the Welsh Government needed to outline how it intended to fund social care and well-being services. He added that the Scrutiny Committee had welcomed previous reports about significant improvements such as the evaluation by the Care and Social Services Inspectorate for Wales (CSSIW) but there had to be recognition of the £1million budget overspend.
In querying the size of the Annual Report, the Chairman stated that he felt that some sections were quite repetitive and he commented that it would be preferable if specific areas were mentioned only once. He also felt that the Director’s Report dealt with service objectives, whereas reports of the Heads of Services were aligned to service areas, and so the same topics would be covered in various parts of the report.
A Committee Member stated that he considered the report was not too long and that it was meant for many different audiences. There was a need for detail which readers could find in the main body of the report and he stated that the report covered all areas. He went on to comment that the report contained warnings and it was therefore important to look at the situation in England and the challenges being faced there. He added that the money would not be available to provide services in the same way, but there were always opportunities to introduce alternative models which were both cheaper and which provided better services. He then referred to an example with the Health Service around best practice. This related to a review undertaken on the take up of acute beds. It was found that at the University Hospital Wales the number of patients that required an acute bed was below 50%, whereas this was above 50% at Llandough Hospital. The Health Board had looked at its service model to ensure that those patients in acute beds were those that needed to be there and were supported with the right staff. He also outlined another example in relation to orthopaedics, in which, 6 surgeons would each carry out the same operation but in their own individual way. He felt that there must be some way of identifying which surgeon best performed the operation. The Member stated that finding best practice was key but he also expressed concern as to whether sufficient money would be available in future years to deliver services.
The Director, in responding to a query on partnership arrangements with Cardiff Council, stated that the situation was improving. He commented on the requirement, following the introduction of the Social Services and Wellbeing Act, to work on a collaborative regional basis and the need to achieve economies of scale and he stated that the Directorate could demonstrate that the Vale Council was itself a good partner.
RECOMMENDED –
(1) T H A T the contents of the report be noted.
(2) T H A T the Annual Report of the Director of Social Services 2015-16 be referred to Cabinet for its consideration.
Reason for recommendations
(1&2) To provide Elected Members with an opportunity to contribute to the challenge process for the Director’s Annual Report 2015-16.
319 JOINT RESPONSE TO THE REPORT FROM THE OLDER PEOPLE’S COMMISSIONER FOR WALES CALLED “DEMENTIA: MORE THAN JUST MEMORY LOSS” (DSS) –
The purpose of the report was to ensure that the Scrutiny Committee was aware of the joint response from the Vale of Glamorgan and Cardiff Councils and the Cardiff and Vale University Health Board to the Older People’s Commissioner for Wales’ report called “Dementia: More Than Just Memory Loss”.
The report advised that on 14th March, 2016, the Older People’s Commissioner for Wales (the Commissioner) released a report which set out what actions those providing public services needed to take in order to ensure that people living with dementia could have the best quality of life for as long as possible. The Commissioner maintained that “delivering this change was not only good for people living with dementia and their carers, but also good for the public purse”.
The actions required to address the issues identified by the research included:
- Work to ensure that primary care services were more dementia supportive and their work practices reflected the needs of people living with dementia and their carers;
- Training for staff to ensure that they had sufficient knowledge and understanding to respond to the needs of a person living with dementia in an appropriate and sensitive manner that protected their dignity and respect and minimised distress;
- Greater post-diagnosis support, including a single point of contact to provide information and advice on the services and support available that could be accessed whenever required.
The Commissioner wrote to public service leaders across Wales, seeking assurances that they would deliver the changes required on behalf of people living with dementia and their carers. In the Vale of Glamorgan, the Corporate Management Team and the Public Services Board considered the report. It was agreed that the response should be regional, given the need for Health and Social Care services to work together in delivering the recommendations. The response was attached at Appendix 1.
The report stated that the region was well positioned to take the plan forward given that it had been implementing its Dementia Three Year Plan. Attached at Appendix 2 was a copy of the End of Year Two (2015-16) report. The actions outlined on page 24 of the report mirrored many of the recommendations made by the Commissioner. Of particular note was the emphasis on carers and respite and also the need to train clinicians to become more aware of the needs of individuals with dementia and their carers.
Having considered the Council’s response, the Committee
RECOMMENDED –
(1) T H A T the contents of the report be noted.
(2) T H A T the action plan developed in response to the report from the Older People’s Commissioner for Wales be noted.
Reason for recommendations
(1&2) To provide Elected Members with information about the Council’s response to the recommendations set out in the report published by the Older People’s Commissioner for Wales, “Dementia: More Than Just Memory Loss”.
320 SCRUTINY COMMITTEES’ DRAFT ANNUAL REPORT MAY 2015 TO APRIL 2016 (MD) –
The Scrutiny Committees’ draft Annual Report for May 2015 to April 2016 was presented for Members’ consideration and approval.
At the Scrutiny Committee Chairmen and Vice-Chairmen Group held on 19th July, 2016, a Scrutiny Committees’ Draft Annual Report was submitted for initial consideration / comment prior to it being formally reported to all five Scrutiny Committees.
At that meeting, Members of the Group raised a number of issues relating to the style / format / layout and length of the report. It was therefore suggested that the work of the Scrutiny Committees be described in a far more concise way, for example simply alluding to a few highlights rather than a detailed description and narrative. Subsequently, the Head of Democratic Services was requested to explore alternative formats for the Scrutiny Committees’ Annual Report and to submit a revised suggested format.
Attached to the report at Appendix 1 was a revised version of the draft Annual Report which was more concise and considered to be more user-friendly in terms of the likelihood of engagement with the public.
At the meeting, the Committee agreed changes to a paragraph in relation to the publication of the Council’s Corporate Assessment.
RECOMMENDED – T H A T the draft Scrutiny Committees’ Annual Report for 2015-16 be approved.
Reason for recommendation
To allow the Annual Report to be submitted to Full Council in September 2016.
321 EXCLUSION OF PRESS AND PUBLIC –
RESOLVED – T H A T under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following item of business on the grounds that it involves the likely disclosure of exempt information as defined in Part 4 of Schedule 12A (as amended) of the Act, the relevant paragraphs of the Schedule being referred to in brackets after the minute heading.
322 UPDATE ON PROVIDER PERFORMANCE CONCERNS – VERBAL UPDATE (IHBMI) (EXEMPT INFORMATION – PARAGRAPH 14) –
The Chairman asked if the Interim Head of Business Management and Innovation could update Committee about concerns in relation to a residential care provider in the Vale of Glamorgan.
Committee was advised that a number of complaints had been received and a number of Protection of Vulnerable Adult referrals were being investigated. An action plan had been put in place and the Directorate would be monitoring the situation very closely.
RECOMMENDED – T H A T the concerns raised in relation to the residential provider be noted.
Reason for recommendation
In order to inform Members of concerns in relation to a residential care provider in the Vale of Glamorgan.