HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE
Minutes of a meeting held on 12th June, 2017.
Present: Councillors Ms. J. Aviet, Ms. B.E. Brooks, G.D.D. Carroll, Mrs. C.A. Cave, S.T. Edwards, K.P. Mahoney, Mrs. K.F. McCaffer, N.C. Thomas and Mrs. M. Wright.
Also present: Councillor G.C. Kemp.
27 APPOINTMENT OF CHAIRMAN –
RESOLVED – T H A T Councillor Ms. B.E. Brooks be appointed Chairman for the Municipal Year.
28 APPOINTMENT OF VICE-CHAIRMAN –
RESOLVED – T H A T Councillor Mrs. K.F. McCaffer be appointed Vice-Chairman for the Municipal Year.
29 APOLOGY FOR ABSENCE –
This was received from Councillor Mrs. R. Nugent-Finn.
30 DECLARATIONS OF INTEREST –
No declarations were received.
31 MINUTES –
RECOMMENDED – T H A T the minutes of the meeting held on 13th March, 2017 be approved as a correct record.
32 INTRODUCTION TO THE HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE –
The Director of Social Services and the Democratic and Scrutiny Services Officer conducted a PowerPoint presentation which provided an introduction to the Healthy Living and Social Care Scrutiny Committee.
In beginning the presentation, the Director referred to the Committee’s role and remit and highlighted that the Committee was required to monitor the Corporate Plan Objectives in ensuring that the Council encouraged and promoted active and healthy lifestyles and also that it safeguarded those who were vulnerable whilst also promoting independent living. The Director also highlighted that there were four key elements within the Committee’s remit, these being:
- Adult Services
- Children and Young People Services
- Social Services Resource Management and Safeguarding
- Leisure, Parks, Sport and Play.
The Democratic and Scrutiny Services Officer then provided an overview of the key elements to the Committee meetings and agendas. These included the following areas:
- Availability of agendas
- Apologies for absence
- Declarations of Interest
- Urgent agenda items
- Part II reports
- Types of meetings.
The Committee was provided with an overview of the call-in process, with Members being advised that this was a mechanism used whereby any individual Vale of Glamorgan Councillor could ask for the relevant Scrutiny Committee to review a decision made by the Cabinet. The Committee was advised that the call-in process contained a five day window in which decisions could be called-in and the Committee would need to consider the call-in within 20 days of the request.
Members were also provided with an overview of Requests for Consideration and how members of the public could participate within the scrutiny process. In addition, the Democratic and Scrutiny Services Officer also briefly outlined the Committee’s work programme and decision tracking functions.
In terms of the structure of the Social Services Directorate, the Director advised that there were three divisions, these being Adults, Children and Young People Services and Resource Management Safeguarding. For each of these divisions, the individual Head of Service provided an overview of their services’ structure. Following this, the Committee received a summary of the key challenges and priorities. The main challenges for Social Care being:
- Budget pressures and Efficiency Savings
- Fragility of Independent Provider market
- Demographics and ageing population
- Expectations of Service users and carers
- Demand Management
- Complex case management
- Capacity of staff to deliver
- Local Government Reform
The following were outlined as priorities for Social Care:
- Protecting People/ Safeguarding
- Financial Sustainability/ Reshaping Services
- Pooled budgets
- Demand Management
- Independent providers – market position
- Information, Advice and Assistance
- Prevention and Early Intervention
- New Models of Service/Strategic Change
- Outcomes Focused Practice
- Social Care and Community Health Services Integration
The Committee was also presented with an overview of Leisure Services. The Operational Manager referred to the key challenges for this service, these being:
- Reshaping services agenda
- Capital Investment
- Ageing workforce
- Reliance on Grants
- Customer expectations
- Equality of service provision
- Performance Measurements
- Subsidy levels (over provision / consolidation in some service provision)
- Developing meaningful partnerships
In terms of priorities for Leisure Services, the Committee was advised of the following:
- Increase Physical Activity levels across the Vale of Glamorgan
- Extend the Leisure Management contract for a further 5 years including the new 5-a-side centre
- Seek additional income opportunities across the service – notably within Parks
- Look for further efficiency savings and reductions in subsidy in some areas
- Maintain high quality of work such as green flag awards, playground refurbishments, changing room refurbishment etc.
- Implement a Leisure Strategy and develop a tree strategy
- New Health Facility at Penarth Leisure Centre
- Secure grant funding for Sports Development and Exercise Referral
- Secure future play scheme provision
RECOMMENDED – T H A T the contents of the presentation be noted.
Reason for decision
33 4TH QUARTER SCRUTINY DECISION TRACKING OF RECOMMENDATIONS AND WORK PROGRAMME SCHEDULE 2017/18 (MD) –
The Democratic and Scrutiny Services Officer presented the report, the purpose of which was to advise Members of progress in relation to the Scrutiny Committee’s recommendations and to confirm the Work Programme schedule for the Scrutiny Committee for 2017/18. Attached at Appendix A was the Committee’s 4th Quarter decision tracking for January to March, whilst at Appendix B was the Committee’s 3rd Quarter decision tracking in relation to October to December 2016. Appendix C contained the Committee’s Work Programme schedule for 2017/18.
The Democratic and Scrutiny Services Officer stated that the Work Programme schedule provided a breakdown of reports anticipated to be considered by the Committee over the forthcoming months. Members were requested to confirm approval of the Scrutiny Committee’s Work Programme with it being noted that the schedule was a proposed list of items for consideration and may be subject to change depending on prevailing circumstances.
In considering the Committee’s decision tracking for 16th January, 2017 at Minute No. 681 in relation to the Community Mental Health Services, the Committee agreed that the status of this recommendation should be changed to “Ongoing” because the Committee considered it important to receive a further update on progress at a future date. All other statuses within Appendix A were approved as were the status of the recommendations within Appendix B.
(1) T H A T the recommendations deemed as completed in Appendix A be accepted as outlined below:
16 January 2017
Min. No. 678 – Update on the Work Undertaken by Public Health Wales, by Dr. Sian Griffiths, Consultant in Public Health Medicine – Recommended
That the presentation by Public Health Wales be referred to Cabinet for its action as appropriate and in particular to highlight the following areas for improvement:
- Stronger links around urban healthy planning, active travel, promotion of urban and rural green spaces as a means to improve physical and mental well-being.
- Greater support for the Vale Food Charter “Food Vale”.
- Efficient joint working and regular sharing of information and priorities.
Cabinet, on 20th February, 2017 resolved
 That the contents of the report be noted.
 That Cabinet reminds the Scrutiny Committee (Healthy Living and Social Care) that this administration has invested in Leisure facilities, including refurbishing many indoor centres and outdoor play areas throughout the Vale of Glamorgan. The Scrutiny Committee (Healthy Living and Social Care) should also be reminded this administration has established 9 Green Flag parks and more outdoor play areas were due to be refurbished during this financial year and beyond.
(Min. No. C3463 refers)
Min. No. 679 – Wales Audit Office Report on Delayed Transfers of Care – Cardiff and Vale Health and Social Care Community (DSS) – Recommended
(2) That the report and Review be referred to Cabinet for its consideration.
Cabinet, on 20th February, 2017, resolved
 That it be noted that the subject of Delayed Transfers of Care in the Cardiff and Vale Health and Social Care Community is debated at regional partnership board meetings and is always subject to attention and focus.
 That it be noted that the reablement teams were working well at Barry Hospital, Redlands House, Hen Goleg and Ty Dyfan Care Home, and the teams should be congratulated on their hard work
(Min. No. C3464 refers)
Min. No. 680 – Revenue and Capital Monitoring for the Period 1st April to 30th November 2016 (DSS) – Recommended
(2) That progress made in delivering the Social Services Budget Programme be noted and be referred to Cabinet for consideration.
Cabinet, on 20th February, 2017, noted the contents of the report.
(Min. No. C3465 refers)
13 February 2017
Min. No. 777 – Request for Consideration of Matter – Barry Hospital Car Park Fines (Councillor Dr. I.J. Johnson) – Recommended
(2) That the request for consideration be referred to Cabinet.
(3) That Cabinet notes the grave concerns of the Committee regarding the failure of the Cardiff and University Health Board to provide a representative to explain the rationale and evidence base behind the new parking policy to Members of the Committee.
(4) That the Leader or the Cabinet Member for Housing and Social Care and Health be requested to write to the Chair of the Cardiff and Vale University Health Board expressing the Council’s grave concerns regarding the lack of engagement and the unwillingness to provide a representative to set out the Health Board’s case in respect of this item.
(2-4) Cabinet, on 20th March, 2017, resolved that the contents of the report be noted and the recommendations of the Scrutiny Committee (Healthy Living and Social Care) be not acceded to as parking at the Barry Hospital was a matter for the Cardiff and Vale University Health Board as they were responsible for the operation of their estate.
(Min. No. C3500 refers)
Min. No. 778 – Revenue and Capital Monitoring for the Period 1st April to 31st December 2016 (DSS) – Recommended
(2) That progress made in delivering the Social Services Budget Programme be noted and referred to Cabinet for consideration.
Cabinet, on 20th March, 2017, noted the contents of the report.
(Min No C3499 refers)
Min. No. 779 – Young Carers: Annual Update Report (DSS) – Recommended
(2) That the report be referred to the Learning and Culture Scrutiny Committee for its consideration.
The Learning and Culture Scrutiny Committee, on 20th March, 2017, recommended
 That the work undertaken to support young carers in the Vale of Glamorgan be noted.
 That annual updates continue to be presented to the Learning and Culture Scrutiny Committee for consideration.
(Min No 948 refers)
13 March 2017
Min. No. 901 – Request for Consideration of Matter (Dr. I.J. Johnson) – Primary Health Care Facility at Penarth Leisure Centre – Recommended
(2) That an update on the proposals be provided in twelve months’ time.
Added to work programme schedule.
Min. No. 906 – Service Plans 2017-21: Adult Services, Children and Young People Services, Business Management and Innovation and Visible Services and Transport (DSS) – Recommended
(2) That Cabinet be advised that the actions relating to Welsh language provision and Equalities have a more important level of responsibility and should also be reported to the Committee.
(3) That Cabinet be advised that the order of risks, as highlighted in the risk evaluation section, be reversed so that the highest areas of risk come first.
(2&3) The Scrutiny Committee’s comments have been incorporated into a report to Cabinet from IDT.
Cabinet, on 3rd April, 2017 noted and accepted the comments and recommendations made by each of the Scrutiny Committees that were outlined in paragraphs 10-16 of the report and resolved that the Service Plans for 2017-12 be approved.
(Min. No. C3517 refers)
Min. No. 908 – Accommodation with Care for Older People (DSS) – Recommended
(2) That a further report on progress in developing a coherent strategy for older people accommodation with care be provided in 12 months’ time.
Added to work programme schedule.
Min. No. 910 – Update on Implementation of the Social Services and Well-Being (Wales) Act 2014 (DSS) – Recommended
(2) That an update on progress of the regional implementation plan be received in six months’ time.
Added to work programme schedule.
Min. No. 912 – 3rd Quarter Scrutiny Decision Tracking of Recommendations and Updated Work Programme Schedule 2016/17 (MD) – Recommended
(2) That the updated work programme shown at Appendix B be approved, uploaded to the Council’s website and be an agenda item at the next Committee meeting.
Work programme uploaded to the Council’s website.
(2) T H A T the updated Work Programme shown at Appendix C be approved and uploaded to the Council’s website.
Reasons for recommendations
(1) To maintain effective tracking of the Committee’s recommendations.
(2) For information.
34 CARDIFF AND VALE SUICIDE AND SELF-HARM PREVENTION STRATEGY 2017-2020 (DSS) –
For this item, the Committee welcomed Dr. Suzanne Wood, Consultant in Public Health Medicine and Fiona Kinghorn, Interim Director of Public Health.
In presenting the Cardiff and Vale Suicide and Self-Harm Prevention Strategy, Dr. Wood outlined that it was important to clarify the definitions contained within the Strategy. Dr. Wood stated that suicide was deemed to be a death which resulted from an intentional self-inflicted act. For suicidal behaviours, this ranged from having suicidal thoughts, planning suicide, attempting suicide through to completing suicide.
With regard to self-harm, this was commonly defined as an intentional self-poisoning or self-injury. This covered a wide range of behaviours, including isolated and repeating events which usually resulted in physical harm. This challenged the individual, families and professionals alike.
In referring to the associated risk factors, Dr. Wood referred to three aspects. The first related to an ‘individual’, which included such aspects like low socio-economic status, mental disorder and alcohol or substance misuse. The second factor was ‘situational’ and these could be things such as job and financial losses, stressful life events, such as divorce and relational or social loss or discord. The third factor included socio-cultural issues such as exposure to suicide behaviours and stigma associated with poor help-seeking behaviour.
The Committee noted that the current trends in relation to suicide for the Vale of Glamorgan had remained fairly static over the past five years, although there had been a slight increase since 2015. A key consideration for the suicide rate related to levels of socio-economic deprivation which showed that twice as many people from the most deprived background attempted suicide when compared with those with the least levels of deprivation.
Mrs. Kinghorn then outlined how it was planned to tackle the main challenges. She referred to the “Talk to Me 2” strategy launched in 2015 which outlined priorities in regard to demographic groups, geographical places and support for care professionals and providers. Mrs. Kinghorn also outlined the strategic direction of the Cardiff and Vale Health Board and outlined the ‘All Lives Matter’ approach which included the following:
- Accessible and appropriate help now and in the future
- Providing positive outcomes for people at risk
- Getting more people trained and making support more accessible
- Support to build emotional resilience
- Frontline staff embracing the Strategy’s vision and values
- Everyone working together.
Contained within the Strategy were nine key objectives, ranging from improved training and nationally developed workplace guidance through to encouraging responsible reporting of suicide and self-harm in the local media in order to reduce stigma. Other key objects related to closer collaboration between care professionals and care agencies and for better planning between departments in order to consider suicide prevention at an earlier stage.
In outlining some of the key achievements to date, Dr. Wood referred to the formation of the multi-agency Suicide and Self-harm Steering Group and the drafting of suicide and self-harm guidance documents. In addition, the physical nature of buildings had been scoped as had training and development options. Furthermore, significant work was underway in collaboration with HM Prison in Cardiff.
With regard to the next steps, Dr. Wood advised that there would be ongoing project management of progress on the strategic objectives and actions. Three key work streams would be developed, the first being to frequently attend sites (locations), the second around training and development and the third work stream relating to HM Prisons. Furthermore, there would be extensive monitoring of suicide trend rates.
The Chairman queried how the Health Board targeted those individuals, particularly children and young people, that did not present themselves to professionals. In reply, Mrs. Kinghorn stated that a key element was looking at the support package available, particularly at the preventative stage and so the key aspect was engaging with younger adults at an earlier stage with a much wider array of support network available. In addition, Dr. Wood added that it was necessary to closely consider risk factors, for which, the key was raising awareness and reducing stigma, as well as providing assurance for young people in order that they were more confident in coming forward.
Further to these comments, the Head of Children and Young People Services noted another important factor relating to the involvement of the Child and Adolescent Mental Health Service and the improvements being made to that service following Welsh Government investment These improvements have included the implementation of an Emotional Well-being Service acknowledging that not all children and young people require the input of a psychiatrist and that involvement at an earlier stage can prevent further deterioration and the need for more specialist services.
A Committee Member referred to concern about the point at which young people that self-harm were identified. The Member queried the impact that the UK Government’s Austerity Agenda had had on Social Clubs and the number of Youth Workers who acted as a “gatekeeper” with those most at risk. In reply, the Head of Children and Young People Services stated that it was important to understand where the Vale was in terms of number of children and young people requiring support. The other thing to be aware of was the work with schools around emotional and wellbeing support.
A Committee Member commented that on average, within the Vale, there were 12 preventable deaths each year and so this was a very important document. The Committee Member queried the membership of the Steering Group, with it being noted that two Service User Representatives had been appointed. Further service user input would also be made via the Amber Project.
A Committee Member queried whether there was any sort of programme which specifically dealt with concerns raised by teachers. In reply, Mrs. Kinghorn stated that the key issue here was training and that teachers were a key group. She advised that an emotional wellbeing service had been developed which worked closely with schools and that this provided support at an earlier stage. It was agreed that Information on the new wellbeing service would be circulated to Members.
(1) T H A T the Cardiff and Vale Suicide and Self-harm Prevention Strategy 2017-2020 be noted.
(2) T H A T an update report on implementation of the Strategy be received in 12 months’ time.
Reasons for recommendations
(1) To ensure that Members are fully aware of how the Council can support the implementation of the Strategy.
(2) In order to ensure that Members are fully engaged with the wide partnership work with colleagues and Public Health.
35 THE VALE FAMILY INFORMATION SERVICE – ANNUAL UPDATE (DSS) –
The Head of Resource Management and Safeguarding presented the report, the purpose of which was to update on the work of the Statutory Vale Family Information Service (FIS).
The report advised that the FIS was a one-stop information service for parents and carers of children and young people aged 0-20 years in the Vale of Glamorgan, as well as for professionals working with families. It provided free information on a wide range of childcare options and activities and support services for children, their families and their carers. The FIS had a website containing information for parents which helped them support their child through their life.
With regard to the latest developments, the Head of Resource Management and Safeguarding referred to the implementation of Dewis Cymru which was a mechanism to search for information on wellbeing services and support. In addition, an Outreach Officer had been appointed subject to satisfactory reference checks that this person would be taking up their role over the next few weeks.
The Committee was also advised that statistics from April 2016 to March 2017 indicated that more contacts were being undertaken through the website and overall there had been a 3% increase from the previous year in enquiries. The Chairman asked for clarification regarding the table in the report and why the numbers had reduced. The Head of Resource Management and Safeguarding advised that an she would notify members via email.
A Committee Member queried how the numbers had been calculated given that some data had been lost. In reply, the Committee was advised that it was based on trends of activity across the year.
There had been many achievements in the past year.
- 115 new children registered on the Index of Children with Disabilities or Additional Needs.
- A joint regional Cardiff and Vale Index newsletter has been developed and the Vale Index model had been replicated in Cardiff. The Index Officer worked across both Authorities, which was achieved by holding two separate part time contracts currently although future consideration should be given to having a joint post across Local Authorities.
- Joint Cardiff and Vale Index promotional materials had been produced.
- 684 new enquirers accessed information from FIS (73% of all enquiries).
- Joint working and promotion carried out with the Families First Advice Line (FFAL) to GPs, health visitors, front line staff and in Llandough Children’s Centre.
- Ysgol Y Deri has achieved Level 1 of the FIS School Certificate of Achievement (one of 19 in total) and 7 more schools (including 2 comprehensive schools) have achieved level 2 (11 in total).
- The service produced another successful Summer Holiday Activity Programme, available online, which resulted in over 11,000 web hits.
- The FIS Team had worked regionally with Cardiff FIS to transfer their Family Support Directories to Dewis Cymru. They were the first FISs in Wales to do this and were now supporting other FISs to migrate their information.
- Social media was used as a key communication tool and the FIS Facebook page now had 1,204 people following the page (376 new followers in the last year). A particular post on a “relaxed performance of Peter Pan” reached 6,100 people and resulted in 386 clicks. A post promoting the new Tax Free Childcare Scheme and encouraging parents to register reached 3,428 people, resulting in 129 link clicks.
- FIS Team played a key role in the production of the Childcare Sufficiency Assessment (CSA) 2016-17.
In terms of key actions for the new year, these included:
- Complete the transfer of the Children and Young People’s Activities Directory to the Dewis Cymru website and encourage providers to update their information;
- Work with the Local Data Unit and other FISs in Wales to support them to build a standalone national FIS database;
- Recruit an Outreach and information Officer;
- Create an online Index registration form;
- Work with health visitors and parent groups to ensure that new parents are aware of FIS, by attending baby clinics and parent and toddler groups;
- Work with schools to increase Index registrations;
- Continuing to work with Job Centre Plus and PACE project to ensure that lone parents are aware of available childcare options;
- Pilot the FIS Certificate with partner agencies, prioritising a childcare setting, Flying Start and the Families First Advice Line;
- Work with Cardiff FIS to produce joint Index newsletters, improving access to information on services for children with disabilities across Cardiff and the Vale and achieving efficiencies for the Vale;
- Attend key events to promote FIS/DIS and Dewis Cymru;
- Work with the Families First Advice Line to ensure parents and carers are accessing information and advice and all support services are available on Dewis Cymru.
Having considered the report, the Committee
(1) T H A T the work of the Family Information Service be noted.
(2) T H A T the potential impact of the Social Services and Well-being (Wales) Act 2014 upon the Family Information Service be noted.
(3) T H A T an annual update on the Family Information Service be received.
Reason for recommendations
(1-3) To ensure effective oversight of social care services.