HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE
Minutes of a meeting held on 9th October, 2017.
Present: Councillor Ms. B.E. Brooks (Chairman); Councillor Mrs. K.F. McCaffer (Vice-Chairman); Councillors Ms. J. Aviet, G.D. Carroll, S.T. Edwards, K.P. Mahoney, Mrs. R. Nugent-Finn, N.C. Thomas and Mrs. M. Wright.
Also present: Councillor G. Kemp.
355 MINUTES –
RECOMMENDED – T H A T the minutes of the meeting held on 11th September, 2017 be approved as a correct record.
356 DECLARATIONS OF INTEREST –
No declarations were received.
357 REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL TO 31ST AUGUST 2017 (DSS) –
The Operational Manager – Accountancy presented the report, the purpose of which was to advise the Scrutiny Committee of the position in respect of revenue and capital expenditure for the period 1st April to 31st August, 2017.
The current forecast for Social Services at year end was a potential overspend of around £1m due to pressure on the Community Care budget. A table and graph setting out the variance between the profiled budget and actual expenditure to date and the projected position at year end was attached at Appendix 1 to the report.
In respect of Children and Young People Services, the major issue concerning this service was he pressure on the Children’s Placement budget which was due to the complexities of the children currently being supported. It was advised that work continued to ensure that children were placed in the most appropriate and cost effective placements. However, it was 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 and / or the complexity of need.
For Adult Services, the major issue concerning this service was the continuing pressure relating to the Community Care Packages budget. It was currently projected that there could be an overspend this year of around £1m. This budget was extremely volatile and was under pressure from significant demographic growth, an increase in the complexity of cases, as well as pressure from care providers to increase fees as a result of the National Living Wage.
Additional funding had recently been announced by Welsh Government for the Social Care Workforce Grant which totalled £30m across Wales and had provided an additional funding of £704k to the Council. This funding had been used to increase the fees paid to domiciliary care providers above the 1% provided within the budget. This additional money from Welsh Government was not sufficient to fund any growth either in number or size of care packages.
The Community Care Packages budget would also need to achieve savings of £200k this year. Further saving initiatives would be considered which may be funded via regional grants. Welsh Government had continued to provide Intermediate Care Fund (ICF) grant to Cardiff and Vale University Health Board to allow collaborative working between Health and Cardiff and the Vale Councils. However, the level of grant funding was not guaranteed on an ongoing basis.
It was proposed that up to £1m be used this year from the Social Services Legislative Changes fund to cover this shortfall.
In terms of Leisure Services, there was currently an adverse variance to the profiled budget. The main reason was due to high costs for vehicles during the start of the Grounds Maintenance season. It was anticipated that this would reduce over the winter months and therefore it was currently projected that the overall budget would outturn on target. Attached at Appendix 2 to the report was a summary of savings to be monitored by this Committee during 2017/18. There were currently no specific savings targets allocated to Leisure Services.
A saving of £320k had been approved for Social Services for the year, however, the way in which this was to be achieved had not be confirmed.
With regard to the Social Services savings targets which related to the Care Package budget reductions, schemes had been put in place to deliver savings in this area by transferring domiciliary care clients to direct payments and by establishing a review team and therefore the saving is projected to be achieved in full.
Appendix 3 to the report provided further details of the savings within the Social Services Budget Programme.
In terms of capital expenditure, Appendix 4 to the report detailed financial progress on the Capital Programme as at 31st August, 2017.
For the Internal refurbishment of Residential Homes, it had been requested that the £10k budget be amalgamated with the £28k budget for the Residential Homes Refurbishment scheme to enable a more co-ordinated approach to the delivery of works.
For Parks and Ground Maintenance Asset Renewal, Section 106 monies of £9k were available to contribute towards the cost of the installation of play equipment at Tre-Beferad and it had been requested that the budget for this scheme be increased accordingly. £50k had been allocated within this budget for the installation and upgrading on new play areas. Quotations for this work had been returned and were less than originally anticipated. This had allowed £4k to be vired from this budget to the Barry Regeneration Partnership, in order to fund a shortfall on the Fforest Community Park scheme due to additional ground works and £14k had been vired to the Romilly Mess Room scheme.
In relation the Social Services reserve for legislative changes, the Operational Manager – Accountancy advised the Committee that this currently had a balance just short of £3m. In previous years, where Social Services had also been projecting an overspend, money had been set aside because any legislative changes would usually come into force very quickly. This meant that the Council had very little time to respond. The Operational Manager confirmed that at present this sum was not committed and could only be used once, on a short term basis. The Operational Manager further advised that the Directorate would have to find savings on an ongoing basis..
A Committee Member commented that budget reductions would only go so far and at some point additional funding would need to be found. In reply, the Operational Manager stated, each year the Council would look at how services were funded and that budget setting would be considered by the Committee during December.
In referring to Appendix 4 to the report and the retention of charges for Capital Programmes, the Operational Manager – Accountancy advised that in regard to contracts for work, the Council would hold 2% of the total in case any defects were identified. This money would only be paid when the Council was satisfied with the work.
The Chairman, in referring to the £1m overspend on Community Care Packages, queried whether there were any budget areas that could offset the overspend. In reply, the Director of Social Services stated that this had already been offset by budget saving. The Director added that small changes now could have a significant impact later on in the year and so it was difficult to predict. It was difficult to find additional funding. He also stated that over previous years, the Directorate had achieved large savings. It was however becoming increasingly difficult to find savings because of increased demographic challenges and a growth in the number of Looked After Children. He advised that a budget programme was in place and the Council had the people and mechanisms in order to meet the challenges.
(1) T H A T position with regard to the 2017/18 revenue and capital monitoring be noted.
(2) T H A T the progress made in delivering the Social Services Budget programme be noted.
(3) T H A T the revenue and capital monitoring report for the period 1st April to 31st August, 2017 in relation to Social Services and Leisure Services be referred to the Corporate Performance and Resources Scrutiny Committee for their consideration.
Reasons for recommendations
(1) Having regard to the 2017/18 revenue and capital monitoring relevant to the Scrutiny Committee.
(2) In order that Members are aware of the progress made to date on the Social Services Budget Programme.
(3) On request from the Corporate Resources and Performance Scrutiny Committee.
358 REPRESENTATIONS, COMPLAINTS AND COMPLIMENTS (DSS) –
The purpose of the report was to advise the Scrutiny Committee of activity, performance and achievements within this important area of work during 2016/17, and improvements planned for 2017/18.
The Social Services Representations and Complaints Annual Report 2016/17 was attached at Appendix 1 to the report.
A new two-stage complaints procedure had been implemented which was summarised as:
Stage1 - Local resolution
The local authority must offer to discuss (either face-to-face or over the telephone) the complaint or representation with the complainant in an attempt to resolve the matter. This discussion must take place within 10 working days of the date when the complaint was acknowledged. Where this approach leads to a mutually acceptable resolution of the matter, the local authority must write to the complainant within a further 5 working days.
Stage 2 – Formal Investigation
A complaint or representation subject to a Formal Investigation must now be investigated by an Independent Investigator from outside the local authority. An Independent Person must also be involved where a representation is considered at the Formal Stage. The Investigating Officer will be required to produce an investigation report, which may include recommendations for the local authority to consider. This stage must be completed within 25 working days of the date the complaint is agreed with the complainant. If the local authority is not able to send a written response to the investigation report within 25 working days due to exceptional circumstances, it must write to the complainant explaining the reasons for the delay and when a response will be provided. The local authority’s response must advise complainants that they have the right to complain to the Public Services Ombudsman for Wales if they remain dissatisfied following this stage of the procedure.
During 2016/17 the Director received 109 concerns or complaints. 53 enquiries and 56 complaints had been received by the three service areas. In referring to enquiries, the Head of Adult Services advised that there was an error in paragraph 9 of the report, with the number of enquiries received during 2015/16 being 42 and not 38.
The Public Services Ombudsman for Wales 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 2016/17, the Ombudsman received six cases involving Social Services in the Vale of Glamorgan. Four of these complaints were not investigated by the Ombudsman. One was currently being investigated and one had been ruled premature.
The Social Services Procedure included timescales within which complainants should have received a response to their complaint. During 2016/2017, there was a reduction in performance, with 59% not having met prescribed timescales. This was a significant increase on the 24% in 2015/16. A number of reasons contribute to this figure, including the complexity of complaints and a change in the way the figures were collated. The overall maximum timescale for stage 1 complaints is 17 working days, made up of 2 days to acknowledge receipt, 10 days to make contact to discuss / meet with the complainant and a further 5 days to send the written response. Previously if the complaint was resolved within 17 days it was recorded as being within timescale but during the last year each stage was looked at in relation to the specific number of days taken.
The most common complaints received by Social Services for 2016/17 were detailed in paragraph 14 of the report, with the most common theme being in relation to the quality or level of service.
Compliments were detailed in paragraph 15, with it being noted that the Directorate received 105 compliments during 2016/17, compared to 28 in 2015/16. This increase was due to the reporting system being updated and improved during 2015/16.
During 2016/17, Social Services received a total of 25 referrals from Members of Parliament and Assembly Members relating to social care services. All of the referrals received a response from the relevant Cabinet Member.
In terms of priorities for improving the complaints and compliments service during 2017/18, the following would be progressed:
- improve the response timescales at Stage 1 by reviewing the support offered to managers and how this information was collected and reported
- encourage staff to forward compliments so that they could be recorded and reported
- continue to attend and actively participate in the monthly Quality Assurance meetings.
A Committee Member, in referring to the two stage complaints process, asked whether this new approach was working. In reply, the Head of Adult Services stated that she believed so as the service was successful in actively responding to all enquiries. In relation to this query, she also advised that the need to fully understand the best way to respond to an enquiry may in some cases delay the process. In addition, the Head of Adult Services clarified that the Annual Update included those enquiries that required involvement from the Complaints Officer. The Committee was also advised that if staff received comments from service users which they considered to be a complaint, then these would be referred on.
The Chairman commented that what came through from the report was a change in mind set, with the service speaking to people sooner. The Committee was advised that the service had one Complaints Officer in post, which had strengthened the support for staff around resolution. The Complaints Officer would deal with the more complicated complaints while other less complex cases were dealt with by the individual teams.
(1) T H A T the contents of the report be noted.
(2) T H A T the Committee continues to receive an annual update 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 regarding the effect upon the lives of individual service users and their carers.
359 SERVICE USER SATISFACTION CONSULTATION – 2017 OUTCOMES AND 2018 PLANS (DSS) –
The Head of Adult Services presented the report, the purpose of which was to ensure that Elected Members were provided with an overview of the ongoing service user engagement activity within Social Services. For this item the Committee also welcomed the Policy and Quality Assurance Officer for Social Services.
Between January and December, the Policy and Quality Assurance Officer for Social Services undertakes an annual programme of consultation, to explore the experiences and views of service users and their families who had been involved with Social Services. The areas of the consultation were underpinned by service priorities as confirmed by senior management at the start of the year.
During April 2016 to march 2017, Social Services explored levels of satisfaction with support and information received on a wide range of services. To ensure that the learning from one area was translated into improvements across the Directorate, issues were collated thematically accordingly to sections of the questionnaires. These were split into the following areas:
- Information, Advice and Assistance
- Services and Support
- Carers / Relatives
- Complaints and Compliments.
In terms of areas where consultation suggested areas of improvement, some service users felt that they would be able to understand information more if it was provided verbally, for example, someone providing general advice about the assessment process. For service providers, it was suggested that some information needed to be more specific, for example detailing daily routines for services such as residential and day services.
In regard to communication and information from social workers, respondents suggested that if it was difficult to respond to queries, then social workers should acknowledge receipt of the query if they could not immediately respond.
In addition, complaints information needed to be consistently provided to service users and their families as some people were still reporting that they were not receiving documentation.
More staff contact was suggested so that the service users could interact with them and reduce social isolation, however, it was acknowledged that there were considerable constraints on staff time.
Having a wider choice of activities was mentioned as an improvement across Social Services settings. Others felt that the appearance of some of the Council buildings was poor and could do with improvement, for example paint work and furniture appeared out of date and required upkeep.
Response rates to consultation could be improved through interviewing more service users and carers, particularly young people. For 2018, questionnaires would be sent to young people via e-mail to enable them to respond in their own time and provide opportunities to ask questions if they wished.
The Committee queried the response rates to the consultation activities. In reply, the Head of Adult Services advised that this was a challenge because the amount of work was vast and so it was difficult to report. Response rates would vary with some service areas having a higher response rate. Members were advised that the Policy and Quality Assurance Officer would be able to provide a report on the individual service areas. In addition, the Policy and Quality Assurance Officer clarified that for each service area, she would consider the context of the information received, for example for young people. She added that there was usually a higher response rate for domiciliary care and she was trying to increase response rates through young people being able to complete an online form and by speaking face to face to people in residential homes.
With regard to comments around the unsatisfactory condition of buildings, the Committee was advised that these related to residential services, which had been fed into the Council’s Improvement Programme.
(1) T H A T the Service User and Carer Consultation outcomes and recommendations be noted.
(2) T H A T the requirement for qualitative measures to be collated in line with the requirements of the Social Services and Well-being (Wales) Act 2014 be noted and that this be incorporated into the current Social Services consultation outcomes.
Reasons for recommendations
(1) To provide Elected Members with information about engagement and consultation activity with service users and carers.
(2) To ensure that the requirements of the Social Services and Well-being (Wales) Act 2014 are met.
360 CHILD SEXUAL EXPLOITATION (DSS) –
The Scrutiny Committee was advised of the current situation regarding the approach taken to tackling Child Sexual Exploitation in the Vale of Glamorgan. For this item the Committee was joined by the Principal Officer, Safeguarding and Performance.
As a background summary, the report stated that sexual exploitation of a child under the age of 18 was illegal under Section 65(1) of the Children Act 2004.
Sexual exploitation of children and young people under 18 involved abusive situations, contexts and relationships where they received “something” (e.g. affection, gifts, money, food, accommodation, alcohol, cigarettes, drugs) as a result of them performing, and / or another or others performing on them, sexual activities.
The main characteristics of child sexual exploitation (CSE) could be summarised as follows:
- perpetrator/s manipulating children and young people into sexual activities
- the perpetrator/s exercising some power over the victim
- the perpetrator/s often using violence and / or intimidation
- the perpetrator/s exchanging material and / or emotional gifts such as money or affection for sexual favours
- the victim was vulnerable in one or more ways
- the victim may be unable to see or acknowledge that she / he was being groomed or abused
- the victim may appear to agree to the relationship or to the abusive behaviour.
Councils play a crucial, statutory role in safeguarding children, including tackling CSE. However, they could not do this alone. It needed the co-operation of the wider community and partner agencies. Councils could use their links with Police, schools, health professionals, and community and faith groups to highlight the signs and ensure people knew where to turn if they had concerns. CSE was a difficult and unpleasant subject to discuss but having these conversations was crucial to effective action. Members would be aware of the independent report by Professor Alexis Jay into the handling of CSE by Social Services and Police in Rotherham between 1997 and 2013. It was highly critical of "collective failures" of political and officer leadership.
CSE was a key priority area for the Cardiff and Vale RSCB this year. It had established a specific sub-group, led by the South Wales Police and including representatives from the NHS, probation and social services to address operational issues. National developments continued under the new Centre of Expertise on Child Sexual Abuse launched by the UK Home Office and led by Barnardo’s. The Centre would become the authoritative source of research and knowledge on tackling child sexual abuse and exploitation, and harmful sexual behaviour.
To date, there had been only one major case in the Vale of Glamorgan where multiple abuse was suspected – this was historical abuse and the investigation took place over a period of years. It involved a significant number of alleged victims, most of whom were resident in other Local Authority areas and all of whom were now adults. Several regional learning events had taken place following a Practice Review. Children potentially at risk and those who may have been abused were safe. The RSCB had carried out a Child Practice Review to see what lessons could be learned. Two senior managers from the Vale of Glamorgan were members of the Child Practice Review Panel.
On the evidence currently available, most children who had been the subject of CSE strategy meetings since the Council started collecting local data had not been victims of organised abuse. The Council could not be at all complacent and considerable efforts were being made to tackle CSE in its area. The Cardiff and Vale LSCB had established a sub-group, led by the South Wales Police and included representatives from the NHS, probation and Social Services, to address operational issues. There was also a pan-Wales group established by the Children’s Commissioner, which was looking at areas requiring national policy and leadership.
At a local level, the Council complied fully with the All Wales Child Protection Procedures in addressing cases of suspected CSE. Where children / young people were considered to be at risk of CSE, an assessment of risk using the Sexual Exploitation Risk Assessment Framework (SERAF) tool was undertaken. Assessments with risk scores under 11 were discussed with the Principal Officer working in this Council and preventative measures were considered. Risk scores of 11 and upwards progressed to a CSE multi-agency strategy meeting. Cases which were seen to indicate “significant risk” were referred automatically to the Directorate’s Principal Officer Safeguarding (Children) who convenes and chairs a multi-agency strategy meeting under the All Wales Child Protection Procedures.
To ensure that the Council was giving due consideration to children or young people about whom there were concerns but where there was not a “significant risk” score on SERAF, the Council now had in place a process whereby any agency or professional body may refer a case for consideration about whether there were agreed CSE concerns. If this was the case, the ensuing assessment would consider these issues and the case was referred to the Principal Officer who considered the level of intervention required. This might range from the provision of support services to proceeding with a strategy meeting involving relevant professionals. In addition, the new processes allowed the Council to capture more effectively data about the number of children where there were sexual exploitation concerns.
There had been 24 initial CSE strategy meetings between April 2016 and March 2017 relating to 23 children, one child having been closed and then re-referred. There were nine review meetings for nine children carried over from March 2016 with ongoing work identified; the number of review meetings in the period April 2016 to March 2017 was 38 relating to 22 children. Of the 24 children referred during April 2016 and March 2017, four were boys. The age range of the children was 12 to 17, most common were 14 to 16. The response to each young person included:
- consideration of any criminal matters by South Wales Police
- consideration of the need to use child protection procedures; and
- support to be provided by Social Services and voluntary organisations as these children were regarded as being particularly vulnerable.
Where ongoing concerns had been identified, review strategy meetings took place for each young person. As stated, most alleged victims were aged 14 to 16 and they shared common characteristics such as poor attendance at school, low self-esteem, self-harm / suicidal thoughts and inappropriate use of the internet and mobile phones. Suspects were usually male and aged 19 to 40.
The South Wales Police had established a CSE team in each of their Basic Command Units. They were staffed by a Detective Sergeant and two Detective Constables dealing specifically with children and young people who were at risk of CSE. In this role, the officers attended all the CSE strategy meetings in the Vale and Bridgend (both areas being part of the same Basic Command Unit). The Officers were now based in Bridgend with the Missing Persons Team. Additionally there was a worker from Barnardo's who was on attachment with the team who undertook visits to all children who went missing, where there were CSE concerns.
The CSE Taskforce meetings established in May 2015 had been expanded. Those in attendance were the Detective Sargent CSE team, Vale Safeguarding staff, Education, the Practitioner Manager for the Social Services Duty Team, a Youth Service representative, a Youth Offending Team representative, Probation, the Looked After Children Nurse, the Safeguarding Nurse, a representative of the 15 Plus Team in Children’s Services, a Licensing Officer, if there were relevant concerns, and Llamau. The meetings took place every other month in the Vale and on a monthly basis in the Bridgend area (because of the higher numbers of children identified in that area).
The South Wales Police received a grant enabling them to employ workers from Barnardo’s to “de-brief” children and young people who had been missing and where there were CSE concerns. The workers looked to try and establish where the children and young people had been when missing and with whom they had been associating. The worker had also undertaken sessional work with identified young people for up to six sessions working specifically to raise their awareness of the risks and their vulnerability of being exploited. The CSE team to which the Barnardo’s worker was attached had since joined with the Missing Persons team and were, as stated previously, now situated in Bridgend.
One of the challenges for professionals working with children and young people who were most vulnerable was helping them to acknowledge that they were at risk of being exploited. Schools in the area were delivering a programme to children which was designed to raise awareness, especially regarding online abuse which involved their peers. Safeguarding training of both teaching staff and School Governors ensured that they were aware of concerns relating to CSE as well as safeguarding in general.
The RSCB had been working to produce a new CSE strategy which would consolidate emerging best practice. Both Local Authorities had developed separate strategies, to reflect differences in referral processes, while sharing their knowledge and experience, and both were operational. Welsh Assembly Government had also commissioned work by Barnardo’s to undertake a review of the present CSE guidance and procedures. The remit of the person designated to undertake the review was that she would make contact with every Authority in Wales and meet with those responsible specifically for the management of CSE work along with partner agencies, both statutory and the private sector. The person concerned had already met with the relevant people in Cardiff and the Vale of Glamorgan and indicated at that time that the work was on a definite time schedule for completion.
The Chairman, in referring to the multi-agency approach, queried which organisation would lead on cases. The Principal Officer, Safeguarding and Performance stated that as an example, in a case with a criminal act, the Police would be involved. If the victim was under 18 then Social Services would be contacted so that an assessment could be undertaken. Therefore, a joint approach would be adopted. She added that all referrals would come to her, through her role as Chair of all Multi-Agency Strategy Meetings. This meant that there was one main point of contact to co-ordinate all agencies involved. The process also allowed for agencies to share information such as those children at risk and “hot spot” areas.
A Committee Member queried concerns with Looked After Children. The Principal Officer advised that of the one case in the Vale, 13 of the children were looked after, although none were looked after at the time of the investigation. These children had become looked after in order to safeguard them from risk and not necessarily because they had been targeted. The Principal Officer also alluded to those children that were regarded as ‘risk takers’ and those who could be exploited because of their life experiences.
With regard to the role of schools and School Governors, the Principal Officer stated that there were two important aspects, the first relating to training and the second around raising awareness within schools. It was important to ensure that different ages were introduced to issues at the most appropriate stage. In addition, the Principal Officer also referred to the role of the Senior Youth Worker, as they worked closely with children and would raise concern around a particular child. This role was now full time and so they would be managing youth engagement and awareness raising, with a particular emphasis on child to child sexual behaviour, which had been of recent prevalence in the news.
In reply to a query regarding the increase in the number of vulnerable children that were homeless in Cardiff, the Principal Officer advised that this came under the jurisdiction of Cardiff Council. They would have their own dedicated officers, although both Cardiff and the Vale had a joint Safeguarding Board and both would use the same procedures.
(1) T H A T the contents of the report be noted.
(2) T H A T the report be referred to Cabinet for consideration.
Reason for recommendations
(1&2) To inform Elected Members about how the Council is carrying out its duties to identify, reduce and eradicate the risk of Child Sexual Exploitation within the Local Authority area.