HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE
Minutes of a meeting held on 12th February, 2018.
Present: Councillor Ms. B.E. Brooks (Chairman); Councillor K.F. McCaffer (Vice-Chairman); Councillors Ms. J. Aviet, G.D. Carroll, Mrs. C.A. Cave, S.T. Edwards, K.P. Mahoney, Mrs. R. Nugent-Finn, L.O. Rowlands and N.C. Thomas.
681 MINUTES –
RECOMMENDED – T H A T the minutes of the meeting held on 15th January, 2018 be approved as a correct record.
682 DECLARATIONS OF INTEREST –
No declarations were received.
683 RESHAPING SERVICES – REVIEW OF LEARNING DISABILITIES DAY SERVICES (REF) –
Cabinet, on 22nd January, 2018, was provided with an update in relation to progress of a review of the Council’s learning disabilities day services. Cabinet had, in principle, approved the proposal for consultation regarding the closure of the existing provision in the Castle Avenue facility, located in Penarth.
The review highlighted that there was a decrease in demand for the Castle Avenue facility which had impacted on the unit cost. As a consequence, it was considered no longer financially viable for the Castle Avenue facility to remain open. It was therefore recommended that this facility be closed within the current financial year 2017/18. This would take place following a reassessment of the needs of the five people currently attending with alternative plans being in place. Where a day service was assessed as not being required, people would be supported to meet their personal outcomes via alternatives, such as direct payments, community provision, their existing supported accommodation provider or a commissioned external service provider. Where a person was identified as requiring a complex needs internal day service, this would continue to be provided, utilising either Woodlands or Trysor O Le as an alternative base.
The primary focus of the report was in relation to the proposed closure of Castle Avenue. It was also important to recognise that attendance over recent years had also declined at Woodlands (Hen Goleg), evidencing the successful implementation of the Day Opportunities Strategy 2014–17 and the move towards a more person centred approach to meeting individuals’ personal outcomes. Attendance at Trysor O Le remained static at around nine people per year. People attending Trysor O Le accessed the community, but due to the complex nature of their needs, they required an adapted building base to receive care and support. There were limited alternatives for people with these needs, which was why the Day Opportunities Strategy had moved the focus from internal day services to specialise in this area for this group of people whilst emphasising the use of community resources for the majority of people with learning disabilities. The emphasis on meeting people’s outcomes through community resources meant that there was less need for traditional day service models.
Learning disability day services staff were employed from Woodlands Day Service, with the Service Manager deploying appropriate staffing across the three current day services as required. As a result of the closure of Castle Avenue, it was not anticipated that there would be any employment implications as staff would be redeployed to support people with learning disabilities accessing their community activities and within the other two day service settings.
Savings associated with the review of day services for people with learning disabilities was £160k (£30k in 2017/18 and £130k for 2018/19). To date, £30k had been identified through internal staffing changes and other efficiency savings. The reshaping of day services as a whole was taking place as part of a phased approach to the transformation of the delivery of day opportunities across the Cardiff and Vale region. Proposals were being developed for the way in which services could be delivered in the future and these would be reported to Members in due course.
A Committee Member commented that he considered that the demand for service was still there and the Member raised concern around whether the service provision offered met the priority needs of individuals, particularly in relation to human contact and respite care. In reply, Operational Manager (Learning Disabilities & Mental Health) advised that respite would still be provided with some individuals choosing alternative provision such as that provided by Innovate. She also commented on individuals who benefitted from not attending a five day a week service, with some individuals preferring other services. In addition, some individuals did not need a service based within a building but required more services out in the community. The Operational Manager (Learning Disabilities & Mental Health) also advised that two other buildings would still remain and these proposals related to the physical building itself.
The Chairman then raised a number of questions. The first was, how would the staff be affected. In reply, the Operational Manager (Learning Disabilities & Mental Health) advised that due to the low number of service users, usually only two staff would be present on most days. Staff would be based within the other facilities so the proposals would not change the level of staffing. The Chairman’s second question related to the plans for the building. Members were advised that discussion with Housing Services was still ongoing about the possibility of the building becoming a supported accommodation setting.
Thirdly, the Chairman sought reassurance that all service users could be accommodated within the other alternative services. In response, the Operational Manager (Learning Disabilities & Mental Health) advised that the care plans for each service user would be reviewed and that there was enough capacity within the alternative arrangements available, siting Third Sector providers and those individuals who would choose to receive a direct payment.
In closing the debate, the Committee agreed that it would endorse the decision to close the Castle Avenue facility, given that the Committee had received the assurance that the alternative options were suitable.
The Committee noted that an update would be provided through a report regarding the Learning Disabilities Commissioning Strategy which was set for October 2018.
Subsequently, it was
(1) T H A T the contents of the report be noted.
(2) T H A T the proposal contained in the report to close the Castle Avenue facility in Penarth, approved by Cabinet in principle on 22nd January, 2018, be endorsed.
Reasons for recommendations
(1) In order to note the review of the learning disabilities day services.
(2) Having considered the proposals following the review of the learning disabilities day services.
684 VALE OF GLAMORGAN COUNCIL ANNUAL SELF-ASSESSMENT (DSS) –
The Director of Social Services presented the report, the purpose of which was to provide Members with the strategic self-assessment of the Council’s performance for the period April 2016 to December 2017 which identified the Council’s achievements and key priorities for 2018/19.
Self-assessments form a core part of the statutory local government inspection processes in Wales. Under the Local Government (Wales) Measure 2009, the Council was required to undertake a self-evaluation of all its services and use this information to inform planning for improvement. The Well-being of Future Generations (Wales) Act 2015 also required the Council to set and review annually its Well-being Objectives in order to maximise its contribution to achieving the Well-being goals for Wales.
The Vale of Glamorgan Annual Self-Assessment was a position statement on the Council's performance over the past year in delivering its priorities. It was intended to provide an honest and balanced account of the Council's achievements and identifies areas where further progress was required. The information contained in the report, in particular the Service Self-Assessments, would be used to inform the Council's Service Plans for 2018/2019.
The Annual Council self-assessment process was an evolving one reflecting the ongoing work to ensure that the process dovetailed with the Council’s other forms of self-assessment (such as the Improvement Plan, Service Plans, the Annual Local Authority Education Service Evaluation Report and Director of Social Services’ Annual Report) and the developing audit requirements of the Well-being of Future Generations (Wales) Act 2015 (WBFG).
The self-assessment format for 2017 built on the Council’s Performance Management Framework developments in 2016/17 and reflected the Council's outcome focused approach in line with its duties under the WBFG Act.
The Corporate Plan Well-being Outcomes formed the framework for evaluating the Council’s performance and achievements, thus enabling the Council to demonstrate its ability to achieve positive outcomes for its residents and secure continuous improvement. These were supported by service based position statements covering all Council services.
This was the second year of reporting performance against the Corporate Plan 2016-2020 and progress was now available for a full year. Consequently, it had been possible to undertake a comprehensive self-assessment presented by the Corporate Plan Well-being Outcome areas for the first time. The self-assessment covered the period April 2016 to December 2017. The report drew on: the individual service self-assessments covering the 14 Service Plan areas; the Council’s progress to date in achieving the Year 2 priorities of its Corporate Plan Well-being Outcomes and Corporate Health priorities; the views of its regulators in the Annual Improvement Report and progress to date in relation to its audit recommendations / proposals for improvement.
Pages 44-56 of the Council's Annual Self-Assessment provided an overview which outlines the Council’s current position as at December 2017, its key achievements to date and priorities for 2018/19 in relation to Well-being Outcome 4, 'An Active and Healthy Vale'.
In addition, the Director added that in summary and for the areas of Social Services and Leisure, the Annual Self-Assessment was generally very positive. A number of developments had been highlighted, particularly in relation to service remodelling and the way that services were delivered. The Director also mentioned that there was an error on page 47 and the amount saved following the commissioning of a reablement unit at Ty Dyfan, should read £338k and not £3.338m.
The Director also advised that the other aspect to highlight was the budgetary pressures for child placements, which for 2018/19 represented much more of a challenge.
The Committee agreed that it would be beneficial if development sessions on the Council’s Self-Assessment process could be arranged for Members. In addition, the Director referred to his Annual Report, which would be coming to Committee in the next few months and this was smaller and more readable. Previously additional sessions had been provided to ensure that members had an opportunity to consider that in detail and so he suggested that these briefing sessions were held again. He also advised that it was planned for the Committee to see sight of Service Plans during March.
Subsequently, it was
(1) T H A T the Council’s Annual Self-Assessment Report and identified priorities for 2018/19 be endorsed.
(2) T H A T the use and contents of the Council’s Annual Self-Assessment as the basis for service planning for 2018/19 be endorsed.
(3) T H A T the current progress reported against previous regulatory recommendations / proposals for improvement arising from local and national Local Government Studies for the period 2011-2015 relevant to this Committee, in order to enable completed actions to be closed and the remaining actions incorporated in and monitored via the Council’s Insight Action Tracker for 2018/19, be noted.
Reasons for recommendations
(1) To meet the requirements of the Local Government (Wales) Measure 2009 and the Well-being of Future Generations (Wales) Act 2015 to undertake a self-assessment of all Council services and use this information as the basis to drive continuous improvement of Council services and to maximise their contribution to achieving the national well-being goals.
(2) So that the Annual Council Self-Assessment reflects the key challenges facing both the Council as whole and informs the Council's plans for improvement for 2018/19.
(3) To ensure the Council implements its regulatory recommendations / proposals for improvement as outlined through the Wales Audit Office's programme of national Local Government Studies for the period 2011-2015.
685 CARDIFF AND VALE OF GLAMORGAN JOINT COMMISSIONING AND POOLED BUDGET FOR OLDER PEOPLE SERVICES (DSS) –
The Director presented the report, the purpose of which was to enable Scrutiny Members to consider joint commissioning arrangements for older people services across Cardiff and the Vale of Glamorgan, including the establishment of a pooled budget for care accommodation.
Part 9 of the Social Services and Well-being (Wales) Act 2014 (SSWWA 2014) requires Local Authorities and the Local Health Board for each region to establish and maintain pooled funds in relation to the exercise of care home accommodation functions by 6th April, 2018. The region consisted of Cardiff and Vale University Health Board (UHB), together with Cardiff Council and the Vale of Glamorgan Council as the statutory bodies within the pooled budget.
The purpose of the pooled funds arrangements was to ensure that Local Health Boards and Local Authorities worked together to maximise their influence to shape the future development of services. This included ensuring there was sufficient capacity and an appropriate range of good quality services to respond to demand.
The work to develop the pooled budget was overseen by the Cardiff and Vale of Glamorgan Regional Partnership Board (C&VGRPB). It was important to recognise that, whilst the C&VGRPB retained the oversight of the development of the pooled budget, the decision making responsibilities (i.e. for agreeing the pooled budget and its management) rested with Cardiff Council, the Vale of Glamorgan Council and Cardiff and Vale UHB.
In addition to the requirement for pooled funds in relation to care home accommodation functions, Local Authorities and Health Boards were also expected to:
- Undertake a population needs assessment and market analysis to include the needs of self-funders;
- Agree an appropriate integrated market position statement and commissioning strategy;
- Agree a common contract and specification (for use between the care home providers and the statutory bodies);
- Develop an integrated approach to agreeing fees with providers;
- Develop an integrated approach to quality assurance.
For the 2018/19 financial year, it was proposed that one pooled budget be established across the region with effect from 1st April, 2018. During the first year of the new pooled budget arrangements, it was intended that Cardiff Council would act as the host organisation for these arrangements. The host arrangements would be reviewed as part of the development of any further joint working agreed by partners beyond March 2019.
Whilst there would be one pooled budget in place, the processes for commissioning and payment for services would still remain with the three organisations as at present, with each partner continuing to be responsible for their own budget and expenditure. The accountability for the functions of the statutory bodies remained with each individual organisation, in accordance with the Part 9 Guidance under SSWWA 2014.
In clarifying how the pooled budgets would be controlled and monitored, the Director advised that Cardiff Council would be the host Authority and that the money would be sent to Cardiff and then returned. ,. The Director added that this way of working was a requirement by Welsh Government, and it was too early to judge how successful this approach would be.
The Director also clarified that the monitoring of the Vale budget remained firmly in the Vale and would still be undertaken by the Scrutiny Committee, with an extra level of scrutiny provided by the C&VGRPB for the transactional pooled arrangement.
In terms of contract monitoring of placements within care homes, the Director confirmed that these arrangements would remain the same, with the most significant change being the introduction of a new common contract model across the region at some point in the future.
Subsequently, it was
(1) T H A T the progress regarding meeting the Part 9 requirements of the Social Services and Well-being (Wales) Act 2014 which includes the establishment of a pooled budget for care accommodation be noted.
(2) T H A T the establishment of a pooled budget for older people care accommodation from 1st April, 2018, with Cardiff Council to act as the host organisation in 2018/19 as agreed by Cabinet on 22nd January, 2018, be noted.
Reason for recommendations
(1&2) To ensure Scrutiny Committee Members are informed of the progress towards and the imminent establishment of a pooled budget for care accommodation for older people.
686 AN OVERVIEW OF MEALS PROVISION FOR ADULT RESIDENTS WITHIN THE VALE OF GLAMORGAN (DSS) –
The Head of Adult Services presented the report, the purpose of which was to provide an update following the closure of the Council’s Meals on Wheels service. In addition, the Committee was also advised of the exploratory work underway with regard to the means of meal provision within other internal services used by people accessing Adult Social Services within the Vale of Glamorgan.
The Council’s Meals on Wheels service ceased in April 2017, following communication with former service recipients notifying them of the Council’s decision. Service users were contacted individually to ensure arrangements for alternative provision were put in place so as to ensure those with an assessed need for a hot meal daily continued to have this need met.
When the service ceased there were 45 people in receipt of Meals on Wheels.
Service users were provided with a range of alternatives, such as the Wiltshire Farm Foods Company (which provided frozen meals which could be heated at the person’s home). The Council had also undertaken significant work with a Social Enterprise, the Food Shed, who at the time did not provide services within the Vale of Glamorgan area but were keen to expand their operation. Service users were asked whether they wished their personal details to be shared with the Food Shed who could then make contact with them to discuss future provision.
The Food Shed was a social enterprise based in Bridgend. They had developed a partnership with HMP Parc Prison to provide freshly cooked meals daily. HMP Parc Prison produced the meals which were delivered by drivers who were employed by the Food Shed. Meals offering meat, fish or vegetarian options and a dessert could be ordered on a short term or more regular basis and were provided on a four week rolling menu.
In March 2017, approximately 41 service users consented that they were happy for their details to be shared with the Food Shed and decided to move to this arrangement. 36 of these service users currently remained active customers with them.
Service Users had continued to be signposted to the Food Shed via Contact OneVale if they contacted the Council for this type of service. It had been reported that only three requests had been received since April 2017. The Food Shed also accepted referrals directly from family / carers, individuals and health professionals.
The Council had maintained an ongoing dialogue with the Food Shed since the Meals on Wheels service ceased to be provided. The organisation reported that customer satisfaction exercises undertaken by the Food Shed had shown that the service they were providing was valued by its customers and many people were happy with the service.
In terms of their future business plan, the Food Shed were looking into sustainability of the service to further reduce their use of grant funding in the longer term. Their aim was to have lasting impact by continuing the service and developing it further across other boroughs. The opening of the Fairfield Centre in Maesteg had provided additional opportunities to generate further income which operated a community café and acted as an additional base for the service to provide catering from in addition to HMP Parc Prison. The Food Shed was intending to expand into the City and County of Swansea in February 2018 and further work was also planned for future coming years.
Wiltshire Farm Foods also operated in the Vale of Glamorgan. They were based in Cardiff and were one of a number of franchises which were based across the UK.
Wiltshire Farm Foods were primarily a food company offering frozen meals. They had an extensive range, making approximately 300 main meals in Trowbridge in Wiltshire (within their own kitchens), with the ability to cater for almost any diet including allergens and deliver free on a daily basis. They had a market leading range of pureed food which had been recognised by the Queen’s Award for Innovation in 2016.
In terms of the target population, they advised that since 2011 they had covered a total of 47% of their Vale of Glamorgan population through the provision and delivery of frozen meals, the areas they delivered meals are indicated below:
- CF61 (Llantwit Major / Marcross)
- CF62 (Barry, Rhoose, St. Athan)
- CF63 (Barry)
- CF64 (Penarth, Dinas Powys and Sully)
- CF71 (Cowbridge, Colwinston).
This indicated that individuals / families approached Wiltshire Farm Foods direct in order to provide meals for vulnerable people.
The Glamorgan Voluntary Services had confirmed that a number of Third Sector organisations provided luncheon clubs and / or meal provision. An exercise was continuing to identify these organisations and at the time of writing several had returned responses, and were also identified through use of the DEWIS Cymru portal, others were yet to respond.
- Dinas Powys – The Royal Voluntary Service (RVS) provided a Friday Lunch Club, with transport provided by Dinas Powys Voluntary Concern (DPVC) - 18 regularly attended. Also, a Meet and Eat Wednesday Lunch Club, no transport provided – 20 attended on average, the Council contributed to the cost of the rental space to facilitate these luncheon clubs to meet;
- Penarth – Group 617 monthly lunch club for veterans;
- Barry – Castleland Lunch Club met in Golau Caredig every Friday – 23 attended on average including Golau Caredig residents and some people supported by Scope;
- Western Vale – Bethal Church, Llantwit Lunch Club on Friday, transport provided by volunteers – 35 attended on average;
- Cowbridge (Llanblethian) – The RVS ran another luncheon club, which the Council supported through rental costs for the town hall. Averaged 12 attendees per week.
In addition to the previous Meals on Wheels service, the Directorate also had catering operations within the Day Services and Residential Care Home parts of the service. An opportunity to consider the provision of meals within day services had been identified.
The Vale of Glamorgan Council provided hot meals for older people, adults with learning disabilities and adults with physical disabilities across three day services centres: Rondel House, New Horizons, Woodlands (both based in Hen Goleg), Castle Avenue located in Penarth and Trysor O Le (operating from The Hub, Barry).
Meals were cooked at two sites, Rondel House and Hen Goleg covering the outreach centres for which meals were delivered on a daily basis.
In order to achieve the savings target associated with the Physical Disabilities Day Services (£60k) the Council had identified an opportunity to consider the potential to change the way that food was provided for older people, people with learning and physical disabilities across the Council with the aim to reduce the costs of meals whilst retaining and, if possible, enhancing quality and choice.
A Committee Member commented that there had been good reason to change the way that the service was delivered. The Member asked how varied was the menu and queried the cost of a meal provided by the Food Shed. The Member also asked whether there was an eligibility criteria. The Director confirmed that no eligibility criteria was in operation and he advised that he was not sure of the cost per meal, but this would be in the region of £4.65. In terms of the menu, the Director advised that the main difference with the new service was that local and fresh produce was used where previously meals were re-heated. In addition, another benefit was that the Food Shed was a social enterprise which was something that the Council should be promoting as this is a requirement under the SSWBAW.
In referring to the number of people who had been using the Meals on Wheels service, a Committee Member stated that they were surprised at how low the number was and the Member commented on people purchasing a ready meal from a supermarket. In response to these comments, the Head of Service advised that the low number of users meant that it was costly for the Council to continue to provide this service. The Head of Service added that many domiciliary care clients would have an element of meal provision through their care visits.
There being no further questions, it was
(1) T H A T the contents of the report be noted.
(2) T H A T the exploratory work underway with regard to meal provision for people accessing Adult Social Care Services within the Vale of Glamorgan be endorsed and for a further report to be received in due course.
Reasons for recommendations
(1) To provide the Committee with an update following recent changes made to the Meals on Wheels service.
(2) To ensure that the Healthy Living and Social Care Scrutiny Committee are aware of the work underway to ensure services remained responsive to the needs of those using them and were consistent with the Council’s Reshaping Services agenda.