HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE
Minutes of a meeting held on 12th March, 2018.
Present: Councillor Ms. B.E. Brooks (Chairman); Councillors Ms. J. Aviet, G.D.D. Carroll, Mrs. C.A. Cave, S.T. Edwards, K.P. Mahoney, Mrs. R. Nugent-Finn, L.O. Rowlands and N.C. Thomas.
761 APOLOGY FOR ABSENCE –
This was received from Councillor K.F. McCaffer (Vice-Chairman).
762 MINUTES –
RECOMMENDED – T H A T the minutes of the meeting held on 12th February, 2018 be approved as a correct record.
763 DECLARATIONS OF INTEREST –
No declarations were received.
764 CARDIFF AND VALE OF GLAMORGAN AREA PLAN FOR CARE AND SUPPORT NEEDS 2018-2023 (REF) –
The Director of Social Services, in referring to the report, stated that on 5th March, 2018, Cabinet had approved the Cardiff and Vale of Glamorgan Area Plan and Area Action Plan for Care and Support Needs 2018-2023. Cabinet had further resolved for the report to be referred to the Scrutiny Committee for its consideration.
As a background summary, the report advised that the Well-being of Future Generations (Wales) Act 2015 inserted Section 14A into the Social Services and Well-being (Wales) Act 2014 which required Local Authorities and Local Health Boards to prepare and publish a Plan setting out the range and level of services they proposed to provide, or arrange to be provided, in response to the Population Needs Assessment (PNA).
The Area Plan and the supporting Action Plan provided the response of the Cardiff and Vale of Glamorgan Regional Partnership Board (CVGRPB) to the findings of the PNA that was published on 31st March, 2017.
A review was undertaken by the CVGRPB in relation to all suggested areas for action to come out of the PNA. This had been done against existing or planned activity and in current partnerships or organisational delivery mechanisms across the region to identify where the work was already being progressed. In addition, mapping work undertaken also reviewed where accountability lay (e.g. Public Service Board, Community Safety Partnership, Youth Progression Board, Safeguarding Board, etc.) as it had been recognise that no everything identified within the PNA fell under the auspices of the CVGRPB.
The mapping also identified the existing strategies and plans in place to respond to the priorities; resources and pooled / aligned budgets; and current performance management / reporting arrangements.
As a result, two documents had been produced. The first was the Area Plan that was attached at Appendix 1 to the Cabinet report which set out the key needs identified within the PNA, along with the priority areas for action in response to the findings. In addition, an Area Action Plan, attached at Appendix 2 to the Cabinet report, had also been developed. This provided the details of how the priorities would be achieved. Both documents also set out the contributions to the Vale of Glamorgan and Cardiff’s Well-being Objectives and the National Social Services Outcomes Framework.
A Committee Member stated that in comparison to Cardiff, the Vale had a higher proportion of older people and the Member stated that she was surprised that the Area Plan was more focused on younger people. The Member added that one other observation she had made was in relation to mental health services. The Member stated that for many years, mental health came under the umbrella of learning disabilities, with many people lobbying for mental health to be its own separate entity. For the new Area Plan, the Member stated that mental health had been placed within the area of Dementia and she raised concern that mental health could become the “poorer relation” with two key areas being grouped together. In reply, the Director agreed with the Member’s comments and stated that one of the challenges around this was how the Council worked on a regional basis. The Director added that the way mental health operated was quite separate from Older People Services and that the planning arrangements had come on the back of the Dementia Strategy that had been brought to the Committee last year.
In referring to War Veterans, a Committee Member stated that statistically the Vale had one of the highest rates in Wales. The Member added that presumably Cardiff had one of the lowest rates and so as there would be work on a collaborative basis, he queried how the differing needs between the two areas would be met. In reply, the Director advised that this was something which the Cardiff and Vale Health Board would lead on, and so it would be appropriate for a response to come from them. Further to this query, another Member commented that he attended 617 Squadron Group, which although being an RAF group, was open to other veterans including former Fire and Police officers. The Member stated that the number of veterans going to this group was high and so this was a key priority area for the Vale.
Having considered the reference from Cabinet and the report, it was
(1) T H A T the contents of the Cardiff and Vale of Glamorgan Area Plan and Area Action Plan as set out in the Appendices attached to the reference and report be noted.
(2) T H A T Cabinet consider the Committee’s request that Adult Mental Health and People with Dementia should be separated out, with both these coming under their own regional priority areas.
Reasons for recommendations
(1) Following consideration of the developing regional plans for Health and Social Care.
(2) Based on the Scrutiny Committee’s point of view that the areas of Adult Mental Health and People with Dementia are too large to be grouped together which may result in one becoming the “poorer relation”.
765 REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL 2017 TO 31ST JANUARY 2018 (DSS) –
The Operational Manager – Accountancy presented the report, the purpose of which was to advise the Committee of the position in respect of revenue and capital expenditure for the period 1st April, 2017 to 31st January, 2018.
The forecast for Social Services at year end had improved to a potential overspend of around £1m. 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.
Children and Young People Services – The major issue for this Service continued to be the pressure on the children’s placements budget, which had resulted in an overall projected £200k overspend at year end. This was due to the increasing complexities of the children currently being supported, which resulted in their placement in very high cost units. 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 and / or the complexity of need. The service held the Social Services Pressures reserve which had been set aside to offset the impact of high cost placements. If required, this reserve would be used to fund the potential deficit at year end.
Adult Services – The major issue concerning this service was the continuing pressure relating to the Community Care Packages budget. The anticipated position had improved from previous months and was currently projecting an overspend at year end of around £800k. However, a letter had been received from Welsh Government on 14th February, 2018 offering grant funding of £369,265 to support Social Services delivery over the period January to March 2018. This funding could be used to fund domiciliary care, short term residential care and minor home adaptations. It was therefore anticipated that this funding would further improve the year end position however a full assessment would need to be undertaken of the actual impact to ensure compliance with the grant's terms and conditions. It should be noted that this funding was one off during 2017/18 and would not be received in 2018/19. The outturn position was still difficult to predict with certainty as this budget was extremely volatile. The service continued to strive to manage growing demand.
It was proposed that up to £800k be used this year from the Social Services Legislative Changes fund and £200k from the Social Services Pressures reserve to cover the shortfall.
Leisure – 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 the Committee during 2017/18. There was currently no specific savings target allocated to Leisure Services.
With regard to the Social Services savings targets which related to the Care Package Budget reductions, while there was significant pressure on this budget and it was anticipated to overspend, 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 was projected to be achieved in full.
Appendix 3 to the report provided further detail of the savings within the Social Services Budget Programme. The Corporate Programme Board and Project Teams overseeing the Plan would continue to monitor and ensure its delivery. As in previous years, ongoing progress updates would to be reported to Committee as part of the overall financial monitoring report for the Directorate.
Appendix 4 to the report detailed financial progress on the Capital Programme as at 31st January, 2018.
Residential Homes Toilet Refurbishments – It had been requested that this scheme be amalgamated with the Residential Home Refurbishment scheme as both related to works in residential homes and this would enable a more co-ordinated approach to delivery of the works.
Flying Start Update and Upgrade ICT Equipment – An emergency power was approved to include a new scheme in the Capital Programme with a budget of £17k to be funded from Welsh Government Grant.
Flying Start Outdoor Play Area and Canopy – An emergency power was approved to include a new scheme in the Capital Programme with a budget of £15k to be funded from Welsh Government Grant and would be located at Ysgol Gwaun Y Nant.
Romilly Mess Room – This scheme was anticipated to be £26k over budget. This was because additional works had been required which were not apparent when the tender documents were being prepared, such as the renewal of the concrete base which had increased costs on this project. It had been requested that the following virements be made to this scheme to fund this shortfall: £2k from Italian Shelter Penarth, £8k from Community Centres and £16k from the Parks and Grounds Asset Renewal budget.
Byrd Crescent Community Centre – Final accounts were now being agreed and it was anticipated that this scheme would cost £6.5k more than budget. The Parks and Grounds Asset Renewal scheme had uncommitted budget of £23k and it had therefore been requested that £6.5k be vired to this scheme.
Improvement Works at Heol Llidiard Community Hall – The Council was awaiting a match funding opportunity from Welsh Government to procure an extension to the building. It had therefore been requested that £15k be carried forward to the 2018/19 Capital Programme.
Having considered the report, it was
(1) T H A T the 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.
Reasons for recommendations
(1) That Members are aware of the position with regard to the 2017/18 revenue and capital monitoring relevant to the Scrutiny Committee.
(2) That Members are aware of progress made to date on the Social Services Budget Programme.
766 QUARTER 3 (2017-18) PERFORMANCE REPORT: AN ACTIVE AND HEALTHY VALE (DSS) –
The Director of Social Services presented the report, the purpose of which was to provide the performance results for Quarter 3, 1st April to 31st December, 2017, for the Corporate Plan Well-being Outcome 4, “An Active and Healthy Vale”.
The report advised that an overall Amber RAG status had been attributed to Well-being Outcome 4, An Active and Healthy Vale. A detailed report outlining the progress towards achieving the Well-being Outcome 4 was provided at Appendix A.
The Committee then asked officers to provide an update for those actions within the appendix which had a Red RAG status.
In beginning with action AS/A006 Maximise the use of the Intermediate Care Fund and the Primary Care Fund to support the development of further integrated services, the Head of Adult Services advised that the recruitment of additional reablement support workers had been delayed but the recruitment process was once again underway.
With regard to action VS/A074, and the completion of a leisure strategy, the Operational Manager – Neighbourhood Services, Healthy Living and Performance stated that this would soon be presented before Cabinet, but approval was still be sought of the associated Equality Impact Assessment. In addition, this had been delayed because of long standing funding issues around Sports Wales, who were the Vale’s biggest single partner organisation.
In relation to progress around action VS/A073 upgrade electrical wiring and changing facilities at Barry and Penarth Leisure Centres, the Operational Manager – Neighbourhood Services, Healthy Living and Performance advised that this was currently out for the tender, with contractors expected to be on site soon. He added that the Council had used an outside consultancy firm in order to advise on how this scheme should progress, this was because there were various complex legal and financial considerations.
With regard to CS/A014, conclude the pilot the Therapeutic Fostering Scheme, the Head of Children and Young People Services advised that this had been concluded and so the RAG status should be Green.
For Action BM/A024, the development of the DEWIS Cymru information portal, the Director advised that the Vale’s performance was more positive when compared to other parts of Wales, so the status for Quarter 4 would be Green. The Director added that the sustainability of the portal needed to be looked at, so this would be considered by the Council’s Insight Board. Furthermore, the Director advised that Social Care Wales were provided a report which had indicated, that in terms of development, the Vale was where it should be and that the performance of the Vale had exceeded other Authorities. Social Care Wales would continue to advise how well the Council was doing. The Director also stated that the portal had been supported by a Housing Officer within Cardiff Council, but this had recently changed with responsibility moving to the new Regional Co-ordinator post, jointly with Cardiff.
Around AS/A015, Review of the Learning Disability Strategy, the Director advised that this Strategy now covered the Cardiff and Vale of Glamorgan region and was due to be completed by September of this year.
In referring to action PD/A017, around customer enquiries, the Head of Adult Services stated that this was now part of the Council wide digital strategy which had led to better accessibility and better information being available.
For action AS/A016 develop robust processes to improve information sharing to enable a smoother transition between Children and Young People Services and Adult Mental Health Services, the Committee was advised that a further update would be provided via e-mail. A Committee Member commented that this was a very current topic in the news with issues around long delays for an 18 year old requiring mental health support being reported. This was not in the Vale as the individual lived in another part of the country. The Member stated that the delays resulted in the individual experiencing suicidal tendencies and so required a period of time in a specialist mental health unit. The Member went on to query whether transition at the age of 25 was a better option. In reply, the Director stated that Adult Mental Health Services were run by the Local Health Board in partnership with the Vale, while services for Children and Young People were run directly by the Council. This meant that there was the added complexity of two partner organisations working together. The Director further advised that as Adult Mental Health Services was run on a health model, the diagnostic criteria sometimes required the patient to be an adult. The Director added that there was a quite distinct health model in place, such as the Child and Adolescent Mental Health Service, and he referred to the need for the Health Board to look at some of the barriers that existed preventing people from receiving timely support.
For BM/A013, relating to safeguarding tools, the Head of Children and Young People Services stated that there were two strands to this. The first related to the awareness-raising work of the Operational Manager Safeguarding and Services Outcomes that had been reported to Members at the meeting held on 9th October, 2017. The second strand was the development of national procedures which was currently on track.
With regard to performance indicator CPM/090 and the percentage of people completing the exercise referral scheme, the Operational Manager – Neighbourhood Services, Healthy Living and Performance advised that from next year this would be a national performance indicator. He added that staff were extremely motivated to improve the performance for this indicator. This, however, was very dependent upon the type of person referred and their motivation to complete the scheme, with staff actively encouraging people to see this through.
For indicator CPM/195 and the percentage of individuals completing substance misuse treatment, it was reported that performance for quarter 3 stood at 62.79%. This was 10% lower than the performance target. It was agreed that an update on this would be sent via email.
A Committee Member, in referring to the level of staff absence due to stress, queried how often were Council staff surveyed. In response, the Director advised that each department and the Corporate Management Team would receive regular update reports to monitor trends. The Director added that the key aspect around stress was that it was not always possible to attribute this to work or personal circumstances. The Council’s Corporate Centre ran a Staff Survey on an annual basis, which for Social Services was pleasing as significant improvement was highlighted in a number of key areas.
Subsequently, it was
RECOMMENDED – T H A T the Quarter 3 performance monitoring report be noted.
Reason for recommendation
To ensure that the Council is effectively assessing its performance in line with the requirement to secure continuous improvement as outlined in the Local Government Measure (Wales) 2009 and reflecting the requirement of the Well-being of Future Generations (Wales) Act that it maximises its contribution to achieving the well-being goals for Wales.
767 TARGET SETTING FOR 2018/19 (DSS) –
The purpose of the report was to present the targets for improvement for 2018/19 for performance indicators aligned to Well-being Outcome 4 – An Active and Healthy Vale.
As part of the target setting process for 2018/19, a review had been undertaken of the existing Corporate Performance Measures (CPMs) aligned to the Corporate Plan Well-being Outcomes and Corporate Health priorities. The Council's Framework of Corporate Performance Measures comprised local Performance Indicators (PIs), statutory PIs and Public Accountability Measures (PAMs). This had ensured that the measures in place provided the best representation of the activities / outcomes required and that data would be available on a quarterly basis for a set of key measures for each Well-being Outcome area thus enabling a balanced assessment of performance each quarter.
In addition to the CPMs, Scrutiny Committees were also being presented with proposed targets for the national Public Accountability Measures (PAMs) for 2018/19 that did not form part of the Council’s performance framework and these had been aligned to their respective Well-being Outcome areas. Whilst the Council’s CPMs would collect and report on its performance in relation to the Council’s key priorities, there was limited opportunity to benchmark this information with others. The additional PAMs would enable the Council to continue to compare its performance in a range of services with Welsh Local Authorities in line with the requirements of the Local Government Measure 2009.
Appendix 1 to the report outlined the proposed targets for the Healthy Living and Social Care Committee. Targets had been set for those performance indicators that were continuing into 2018/19. A number of indicator amendments and deletions were proposed for 2018/19 following the review of existing CPMs and Members were asked to endorse these.
In total there were 54 measures proposed for collection during 2018/19, 49 of which were existing measures that were due to be carried forward in 2018/19. The Corporate Performance Framework was made up of 29 measures aligned to the delivery of the Corporate Plan's Well-being Outcome 4. In addition to this there were 22 additional measures that had been identified as statutory performance measures that were not directly linked to Corporate Plan delivery but could be aligned to the Well-being Outcome for monitoring. As part of this statutory data set, four measures were Public Accountability Measures (two of which were new PAMs relating to the National Exercise Referral Programme). The collection and reporting of these PAMs would enable the Council to continue to benchmark its performance with other Local Authorities. The other 18 additional statutory measures were Welsh Government derived measures that were aligned to the delivery of the Social Services and Well-Being Act.
There were three performance measures that were proposed for deletion from the existing 2017/18 framework (CPM/186, CPM/195 and CPM/090) which related to substance misuse and the exercise referral programme. A rationale for these proposed deletions had been provided in the Appendix. There were also three new performance measures that had been proposed for inclusion in the Corporate Performance Framework for 2018/19, all of which related to substance misuse data. A rationale for proposing these new measures was provided in the Appendix.
Of the 29 measures that made up the Corporate Performance Framework, targets had been proposed for 24 measures. For five measures target setting was not applicable (CPM/182, CPM/183, CPM/184, CPM185 and CPM/191), because the Welsh Government data set had not been disaggregated at the Local Authority level, so data was not available.
Having considered the targets, it was
RECOMMENDED – T H A T the proposed targets for 2018/19 aligned to Well-being Outcome 4 be endorsed.
Reason for recommendation
To ensure the Council reports a relevant set of performance indicators against which it can demonstrate achievement of its Well-being Outcomes and consistently set challenging yet realistic performance improvement targets for those priorities in line with the requirements under the Local Government (Wales) Measure 2009.
768 SERVICE PLANS 2018-22: ADULT SERVICES, CHILDREN AND YOUNG PEOPLE SERVICES, RESOURCES MANAGEMENT AND SAFEGUARDING, AND NEIGHBOURHOOD SERVICES AND TRANSPORT (DSS) –
For consideration, the Committee was presented with the Service Plans for Adult Services, Children and Young People Services, Resources Management and Safeguarding, and Neighbourhood Services and Transport.
Service Plans for 2018-22 specifically identified how each Head of Service would contribute towards achievement of Corporate Plan Well-being Outcomes by asking two questions:
- "Which well-being objectives does the service contribute to and what actions will we be taking this year to achieve these?”
- “How will we manage our resources to achieve these actions and support our service?”
Appendix 1 to the report contained the Service Plans for those services which contributed to the Wellbeing Outcome the Committee was responsible for monitoring (Adult Services, Children and Young People Services, Resources Management and Safeguarding; and Neighbourhood Services and Transport. Key areas of note within the Service Plans were:
- Section 1 – Introduction: Set the context for the Service Plan and provided an overview of the service area, the purpose of the plan, and the key service considerations which had informed development of the Plan;
- Section 2 – Our Priorities for 2018-22: Outlined the specific actions that the service would be taking during 2018/19 to contribute towards the Corporate Plan Well-being Objectives and Outcomes and the relevant Scrutiny Committee responsible. It also identified the key enabling actions the service would be taking to support its achievement of the Well-being Outcomes, for example through reshaping of its services;
- Section 3 – Outlined what actions the service would undertake during 2018/19 to contribute to Year 3 of the Corporate Plan Well-being Outcomes and Objectives. It also described how the service would manage its resources to deliver its priorities in the Service Plan and outlined key workforce development priorities, significant ICT projects, required budget savings and areas of focus in relation to assets, procurement and major capital projects. This section also identified how the service would engage with stakeholders and work in partnership/ collaborate to achieve its priorities and incorporated a service risk evaluation;
- Appendices A and B (within the Service Plan) contained the Service's Improvement Action Plan for 2018/19. This identifies planned service actions, intended outcomes and key milestones, relevant performance measures to demonstrate progress, responsible officer, timescales for completion and the anticipated resources requirements of planned actions. Appendix C detailed the risk evaluation scores for service specific risks and those corporate level risks which impacted on the service;
- The Children and Young People Service Plan incorporated its contribution to two other Well-being Outcomes, namely Outcomes 1 and 3. It was noted that the proposed actions relating to those Well-being Outcome areas that did not form part of the remit of the Committee had been struck through within the Plan;
- The Neighbourhood Services and Transport Service Plan also incorporated its contribution to one other Well-being Outcome, namely Outcome 2. It was noted that the proposed actions relating to those Well-being Outcome areas that did not form part of the remit of the Committee had been struck through within the Plan;
- All Service Plans incorporated the actions CP1 and CP2 demonstrating commitment to the Council’s corporate priorities; reshaping services and the Council's Workforce Plan. Each Plan also included AC10 and AC12 demonstrating contribution to the Corporate Plan priorities around equalities and Welsh language respectively, which fell within the remit of the Learning and Culture Scrutiny Committee. Progress against these would be reported via quarterly performance reports to the relevant Committee
A Committee Member queried the actions being undertaken to improve lighting of public footpaths. In reply, the Operational Manager Neighbourhood Services, Healthy Living and Performance advised that improved lighting would be considered where it had been identified as being essential and where a risk assessment had been undertaken.
Referring to Action A7 to seek further opportunities to recruit volunteers for service initiatives, a Committee Member highlighted the Vale’s Timebanking pilot, where volunteers would receive credit for any voluntary activity they had undertaken. In response, the Operational Manager Neighbourhood Services, Healthy Living and Performance advised that this was something that the Council was looking at. This action mainly related to summer sporting events and having enough volunteers to support them. The Officer stated that it was fair for the volunteers to be rewarded in some way.
Subsequently, it was
RECOMMENDED – T H A T the Adult Services, Children and Young People Services, Resources Management and Safeguarding, and Neighbourhood Services and Transport Plans for 2018-22 be endorsed.
Reason for recommendation
Following consideration of the Service Plans as the primary documents against which performance for the Corporate Plan Well-being Outcome 4 would be measured.