18-07-10

HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE

Minutes of a meeting held on 10^th July, 2018.

Present: Councillor K.F. McCaffer (Chairman); Councillor Mrs. R. Nugent-Finn (Vice-Chairman); Councillors: Ms. J. Aviet, Ms. B.E. Brooks, G.D.D. Carroll, Mrs. C.A. Cave, S.T. Edwards, K.P. Mahoney, L.O. Rowlands and N.C. Thomas.

128 MINUTES –

RECOMMENDED – T H A T the minutes of the meeting held on 12^th June, 2018 be approved as a correct record, subject to it being noted that Councillor N.C. Thomas was in attendance in place of Councillor O. Griffiths.

129 DECLARATIONS OF INTEREST –

Councillor Mrs. Cave declared an interest in respect of Agenda Item No. 4 – Development of a Locality Model of Community Mental Health Provision Across the Vale of Glamorgan. The nature of the interest was that Councillor Mrs. Cave worked in the area of mental health but the nature of the interest was not prejudicial. Councillor Mrs. Cave remained for this agenda item.

130 DEVELOPMENT OF A LOCALITY MODEL OF COMMUNITY MENTAL HEALTH PROVISION ACROSS THE VALE OF GLAMORGAN (DSS) –

The Operational Manager – Mental Health and Learning Disabilities presented the report, the purpose of which was to update the Scrutiny Committee on developments in community services for adults with mental health problems in the Vale of Glamorgan. For this item, from the Local Health Board, the Committee welcomed Mr. Ian Wile, the Director of Operations (Mental Health Clinical Board), Mr. Mark Jones, Directorate Manager – Adult Mental Health and Mr. Dan Crossland, Project Manager.

Within the Vale of Glamorgan, Social Services staff worked in partnership with the Cardiff and Vale University Health Board (UHB) in three Community Mental Health Teams (CMHTs), working to the GP surgeries in the Central, Eastern and Western Vale areas of the Local Authority area. Currently the teams were based in Cowbridge, Hafan Dawel in Penarth and the Amy Evans Hospital in Barry.

CMHTs in Cardiff and the Vale were jointly operated by the UHB and the Local Authorities. They offered a specialist multidisciplinary service including community based outpatients and psychological interventions as part of a whole system in conjunction with in-patients, crisis and home treatment teams, liaison services and a range of specialist community teams such as peri-natal, assertive outreach, borderline personality disorder, forensic, rehabilitation and eating disorders.

There had been a number of changes that had impacted on the operation of CMHTs, in particular the development of Primary Mental Health Support Services (PMHSS) and the Mental Health Measure (MHM). These were intended to support CMHTs to focus on those people with the most complex needs. In addition, over the last few years the traditional role of CMHTs had changed with the introduction of Crisis Resolution and Home Treatment Teams and other specialist teams which had impacted on the way CMHTs worked.

CMHT staff also described how the nature of the mental illnesses were becoming more complex and diverse with issues such as dual diagnosis, neuro-developmental disorders and personality disorders increasingly evident. The interpretation of secondary care responsibility had become more diverse as a consequence. This had been a challenge to services. All teams had an appointed Integrated Manager in post whose responsibility included overall responsibility for the integrated pathway and service user experience through the CMHT from referral to discharge.

In response to increasing referral demands, a community review of the service was begun in 2015. Following this initial review, a programme of work commenced in January 2018, sponsored by the Mental Health Clinical Board to consider the future service model for delivering CMHTs.

It was subsequently proposed that the three current CMHTs operating across the Vale of Glamorgan should be co-located to Barry Hospital. Capital planning within the Cardiff and Vale UHB had secured funding through the Integrated Care Fund to enable accommodation for the amalgamated Vale Community Mental Health Service at Barry Hospital in late summer / early autumn.

Given concerns regarding the suitability of current premises to accommodate staff and provide services to people with mental illnesses, coupled with health and safety risks, the Vale Council was supportive of the proposed co-location to Barry Hospital later this year. This meant that the staff would move from the Amy Evans Hospital, Cowbridge and Hafan Dawel, Penarth to Barry Hospital.

There would be an ongoing period of staff consultation which was due to end on 8^th July, 2018. The intention, depending on the outcome of the consultation, was that the Community Services programme would oversee the timely delivery of the co-location of the three Vale teams into Barry Hospital with the proposed establishment of an integrated locality management structure to support the teams.

In addition, the community services review suggested the merging of team processes to ease duty pressures and release practitioners’ time to allow them to spend time with service users on their caseloads to address their care and support needs in a more effective and timely manner. It was also hoped that this would address the concern with patients having to be continually assessed.

The review was also seeking opportunities to provide outreach / satellite services through clinics at Cowbridge and Penarth to ensure that staff provided services in communities. One proposal was to consider provision of the services at the Wellbeing Hub proposed in Penarth, located on the Cogan Leisure Centre site, although this was still in the early planning stage.

The details of the consultation document outlining the rationale for change and the options considered were outlined in Appendices 1 and 2 to the report.

Mr. Ian Wile, the Director of Operations added that changes would be progressed over two phases. The first would be to ensure that accommodation was safe and the second related to using the expertise of Mr. Dan Crossland, the Project Manager, so that a patients journey through the service was simplified, which would also lead to a reduction in waiting times. Mr. Wile also outlined that during consultation, concern had been raised with the distance to Barry that some patients would have to travel. In clarifying this point, Mr. Dan Crossland, the Project Manager advised that service user numbers in the western part of the Vale was low, with 38 clients regularly attending clinics. This meant that most individuals received support at home. There were 258 individuals who received infrequent outpatient support so it was hoped that preference for each individual patient would be looked at.

A Committee Member stated that the intention to create co-ordination across the Vale was welcome but there were concerns for some patients attending Hafan Dawel. The Member stated that he was aware of one case where the individual would not be able to travel across the length of the Vale due to their illness and so if they had to go to Barry Hospital, then there was a fear that their treatment may stop. In reply, the Mr. Crossland, the Project Manager stated that there would be consideration of the specific needs of all individuals through the Equality Impact Assessment. In addition, they would look at one of the two satellite bases which could potentially support the individual or they would look at the support available for the individual at their home. The intention would be to create more specialised and assertive outreach services for those hard to engage individuals. This would be to ensure that there was provision for that, as services currently run by the CMHTs were inadequate, and so there was a need for a better level of provision.

In commenting on the practicality of the proposals, a Committee Member queried whether the moving of staff would be undertaken gradually and how would this impact on patients. The Member also queried whether there would be a separate entrance for patients at Barry Hospital and whether there were plans to address the issues of patients having to be continually assessed. The Member also raised concerns regarding out of hours operations and asked whether better support for this would be available. In reply, the Project Manager stated that the project would be undertaken over two phases, the first phase would include staff at the Amy Evans building, with cover provided by staff from the western Vale and Hafan Dawel. It was not currently anticipated that there would be any difficulties with the staff transition. Information regarding the proposals would be shared on an individual basis and through GP clinics. With regard to the Barry Hospital entrance, Committee was advised that there would be a discreet entrance on the right hand side of the building and so clients would not have to use the main entrance. For out of hours operations, the Local Health Board were currently considering flexible working arrangements which would allow more opportunity for an extended service. In addition, Mr. Wile, the Director of Operations, stated that there were only two crisis teams in Wales and there was a need to look at the level of discreet services available as it was evident that the Vale did not have enough provision.

The Director of Operations also added that the new locality model would benefit from the strong relationships that would be formed. With new specialist services based in the Vale it was hoped that patient information would then flow more quickly, which would also mean that patients would then undergo fewer assessments.

Having thanked the officers for the update, a Committee Member stated that it seemed a shame that the service would be based within a hospital, although it was recognised that there was very little alternative. The Member queried how would progress be evaluated and whether the good services in the western part of the Vale would be maintained. The Member also stated that concern had been raised regarding the distance that some service users from the western Vale would have to travel.

Councillor E. Williams, not a Member of the Committee but with permission to speak, stated that he noted that the number of patients affected was in the tens, but he had seen very little information regarding timescales around proposals to create satellite clinics and the effect this would have on service users. In reply, Mr. Crossland, the Project Manager stated that this would depend on the individual needs of each service user, but it was hoped that rooms could be made available within G.P. surgeries. Therefore a scoping exercise was currently underway. Mr. Crossland also added that at present there were currently a large number of individuals who already travelled to Barry for their support and so distance was not the barrier that it may first appear. Going forward a key part of the work, would be to talk to each service user in order to consider their concerns on an individual basis.

Furthermore, Mr. Wile, the Director of Operations, also referred to the specialist support that was available in Cogan four days a week, which was an example of new ways of working. The Chairman asked for an update in regard to this facility. In response, the Committee was advised that a capital bid for funding had been submitted. Furthermore, the Operational Manager for Neighbourhood Services, Healthy Living and Performance, stated that the project group had met on two occasions and Welsh Government was aware of the proposals. Welsh Government had indicated that it required more detail on the services to be provided at the hub and so the Scrutiny Committee would be provided with a full synopsis in a few months’ time. The proposals had been agreed in principle but would require a further Cabinet report for approval.

The Committee asked whether it would be possible for an update on the Mental Health provision to be provided to the Committee in three months’ time. In reply, Mr. Wile confirmed that it was.

There being no further questions, the Committee

RECOMMENDED –

(1) T H A T the contents of the report be noted.

(2) T H A T an update report be presented in January 2019.

Reasons for recommendations

(1) Following consideration of developments in community mental health services in the Vale of Glamorgan which would help to meet increasing public, service user and policy expectations.

(2) In order to provide the Scrutiny Committee with an update on progress.

131 FAMILIES FIRST 2017-18 ANNUAL UPDATE (DSS) –

The Prevention and Partnership Manager presented the report, the purpose of which was to provide an update on progress and activity in the Welsh Government grant allocated to support the delivery of the Families First Plan 2017/18 in the Vale of Glamorgan.

The Families First Plan was initially developed in 2012 and focused on a support network of provision and services aligned to a 'team around the family' approach.

Families First funded the co-ordination and support of services, the provision of a dedicated family support service (FACT – Families Achieving Change Together) and a range of bespoke projects that supported the long term aims to improve the life chances of children and young people from disadvantaged families.

Eight distinct projects existed under the Families First Plan 2017-18:

FACT – internally commissioned (Social Services);
Disability Focus – internally and externally commissioned;
Partnership for Young Parents – internally commissioned (Social Services);
Putting Families First – internally commissioned (Education);
Youth Support Programme – internally commissioned (Education);
Young Carers – externally commissioned;
C-Card scheme – internally commissioned (Education);
Central co-ordination – internally commissioned (Education).

The Families First Management Board had also overseen two further pilot projects, the Families First Advice Line (FFAL) and Parenting and Youth Reshaping. FFAL was managed through FACT and had been particularly successful. Children, young people and / or families were referred through a central formal referral system (584 calls had been received between April 2017- March 2018) to a team who offered advice and signposting and if appropriate undertook assessments. This had proved successful in reducing the overall number of referrals to FACT and improved the appropriate nature of referrals. There had been a decrease of 4.9% (159) accessing the FACT project from 2016/17 in response to the implementation of the FFAL.

The second pilot was informed by planned changes to Families First by Welsh Government. All Local Authorities were informed early in 2017 that they would need to make additional changes to their Families First programmes, based on emerging priorities that would be made clear within the new Families First Programme Guidance launched in April 2017. All Local Authorities would also have a transitional year (April 2017- March 2018) in which to make this step change.

Welsh Government issued a set proforma for an Annual Progress Report, this required details about a number of specified areas linked to the Families First Guidance and an update on all projects. The Annual Progress Report gave an overview of some of the main outcomes and achievements during the year.

Individual project progress during 2017-18:

FACT - internally commissioned and delivered via Social Services; 68 families completed a Joint Assessment Family Framework (JAFF) and 51 post JAFF closure assessments. Referrals from Children and Young People Services (where these have not met threshold for statutory intervention or require a 'step down' service), have remained high, and many cases remain open between 8-12 months due to complex needs. The rate of JAFFs closed with a successful outcome was 94.12%.

Disability Focus - centrally delivered through the Co-ordination team, and consisting of a series of interlinked projects all offering different services to families with disabled children (412 accessed) and young people (123 accessed).

569 families were now registered on the Disability Index, the Index newsletter had become a regional, Cardiff and Vale newsletter, which made information on services and support for children with disabilities across Cardiff and the Vale more accessible.

70 disabled children had accessed inclusive play opportunities.

Vale 'Youth Speak Up' had provided self-advocacy for 30 learning disabled young people, who had registered for 42 accredited training opportunities. This provided a platform for disabled children and young people to have a voice. Five of these young people represented Vale Youth Speak Up on local and national forums.

34 disabled young people had undertaken travel training, giving them the key skills and confidence to travel in an independent capacity using public transport. 83% of young people were still travelling independently six months after completion the 1:1 travel training.

26 young people undertook 1:1 Independent Living Skills (16 -19 years old) and another 50 undertook this within a group setting. This aimed to support disabled young people to develop skills such as personal care, cooking, budgeting etc. 79.5% of young people stated that their independent living skills improved on completion of the programme.

Partnership for Young Parents – internally commissioned (Social Services); worked with young mothers (up to 19 years) and their partners across the Vale of Glamorgan. Since 2013/14 this programme had undergone a huge transition, extending its service from the Barry area to the whole of the Vale of Glamorgan. The programme broadened its services to offer Midwifery, Early years, Support and Education. A specialist young person Midwife supported all 60 pregnant teenagers in Vale of Glamorgan. 46 young mums and pregnant teenagers received 1:1 support and 35 of these received early years support, in the form of bumps to birth and other parenting courses, with a further 20 partners being engaged.

Putting Families First – internally commissioned (Education); focus was to remove barriers to engagement for parents through a raft of individual and group activities within seven targeted schools. 533 families accessed the programme undertaking parenting programmes and accredited courses such as Reading Readiness, Ready for Maths and First Aid. 48 parents completed a Family Links Parent Nurture course (not accredited), 210 parents completed an accredited programme and 83 parents attended the six week baby massage class. 95.5% of participants stated they felt more confident in themselves and their abilities following the intervention.

Youth Support Programme – internally commissioned (Education); The project had two elements to target young people aged 8 to 19, 192 individual pupils completed a personal transition plan to help them manage emotional and behavioural issues occurring during their transitional period from primary to secondary school providing them with coping techniques. 100% of these pupils had identified that they had benefited from the intervention, including improved mental and emotional wellbeing. EMOJIS an intensive support programme, delivered out of school time, targeting young people aged 8 to 14 who had been identified as having emotional and behavioural issues. Of the 28 students who completed 93% gained an accreditation from the programme. 97% of the students who completed stated that they were better able to cope with day to day issues, following the intervention.

Young Carers – externally commissioned; provided a bespoke 1:1 support in the home and respite provision for young carers (aged 7 - 18) to help improve the Young Carers and their families’ resilience. 53 Young Carers accessed the project, 18 received 1:1 support in the home. 94% stated they felt less isolated as a result of accessing the project and that the programme had improved at least one aspect of their life.

C-Card scheme – internally commissioned (Education); the aim of the project was to reduce sexually transmitted infections and pregnancy rates for young people aged 14 to 19. The project provided access to sexual health support via C-Card which allowed access to condoms and sexual health information in places and at times convenient to them, including during the school holidays. The Sexual Health Officer (SHO) provided Sexual Health Lessons at four comprehensive schools reaching 846 pupils. 100% of pupils stated that the Sexual Relationship Education training was beneficial to them and that now they had a better understanding of relationships. The SHO also provided 12 identified young people with 1:1 support.

Central co-ordination – internally commissioned (Education). The Co-ordination Team were responsible for the strategic management of the Families First programme in the Vale of Glamorgan. They had supported over 300 individual workforce development opportunities, commissioned services, reported on outcomes for Welsh Government, delivered various events including a 'Pupil Well-being' event in November 2017, with a 107 education and support staff attending the event, there were 25 information stands and feedback received was very positive and had led to the establishment of a Wellbeing Forum.

The new Families First guidance (April 2017) changed the focus of the funding to build on the previous requirements. The Families First Management Board sought stakeholder involvement through an event held in May 2017. The event highlighted the change in direction of Families First and linked this to the locally developed needs assessment and the Adverse Childhood Experiences Report. The event allowed stakeholders to shape ideas, suggestions and changes going forward, and a new Families First Plan was submitted to Welsh Government in November 2017.

As a transitional year, all new developments within the plan were to be initiated by April 2018. Two new teams, Parenting and Youth Wellbeing, had been created, live from April 2018 with a formal launch scheduled for October 2018.

From April 2018 the funding was utilised to deliver the following projects:

Team Around the Family project (FACT) – internally commissioned and delivered via Social Services.
Disability Focus – internally and externally commissioned (some on a regional basis).
Young Carers – externally commissioned.
Wellbeing Youth Mentoring Service (this absorbed both the Youth Support Programme and the C-Card projects) – internally commissioned and delivered via Learning and Skills.
Parent Support Project (this absorbed Putting Families First, the Partnership for Young Parents and incorporated some element of the Flying Start parenting service).
Families First Advice Line (building on the success of the pilot) – internally commissioned and delivered by FACT (Social Services).

The proposals for the use of Families First funding were in line with the well-being objectives in the Public Services Board's draft Well-being Plan, in particular the well-being objective 'to give children the best start in life'. The proposals were also consistent with work being undertaken by the Cardiff and Vale Integrated Health and Social Care Board to address the priorities identified by the Population Needs Assessment.

A Member queried why the C-Card scheme and the Well-being Youth Support Programme were only available at certain schools. In reply, the Prevention and Partnership Manager stated that these schemes were community outreach services provided to some and not all schools. The projects had been targeted to those schools that required the most support with workers focused on one or two schools.

The Committee Member then asked what would the impact be following the restructure of the Youth Services. In reply, the Prevention and Partnership Manager stated that the number of staffing hours was due to increase.

A Committee Member stated that the purpose of Families First was to prevent escalation to statutory services, and the Committee Member asked how effective was Families First at doing this. In reply, the Prevention and Partnership Manager stated that it was widely felt by all 22 Authorities across Wales, who agreed that the Families First programme had helped achieve savings, but it was difficult to assess what intervention would have been provided if Families First was not available. In his opinion, he advised that Families First was very successful.

A Committee Member then asked two questions. The first related to paragraph 12 of the report and the 70 disabled children that had accessed inclusive play opportunities. The Committee Member asked the officer to expand on this. In reply, the Prevention and Partnership Manager advised that this related to the school holidays and attendance at play schemes and support facilities at Ysgol y Deri. The Member’s second question related to the EMOJIS programme and what support was available after the child turned 14. In reply, the Committee was advised that should there be a need then individuals would be referred for 1:1 support.

Having considered the report, it was subsequently

RECOMMENDED –

(1) T H A T the contents of the report be noted.

(2) T H A T the positive work undertaken to support children, young people and families in the Vale of Glamorgan be noted.

(3) T H A T an update report be received by the Committee on an annual basis.

Reasons for recommendations

(1&2) To ensure that Members are kept informed about positive progress made around the development of Families First.

(3) In order that an update be presented in 12 months’ time.

132 CLOSURE OF ACCOUNTS 2017/18 (DSS) –

The Operational Manager – Accountancy presented the report, the purpose of which was to inform the Committee of the provisional financial position of the Council for the 2017/18 financial year.

Children and Young People Services – Adverse Variance of £137k

There was an adverse variance of £512k relating to the Children's External Placements budget. This was due to rising demand and the challenges associated with placement availability increasing reliance on the external placement market, alongside the increasing complexities of a small cohort of the children currently being supported, which resulted in their placement in very high cost provision. Work continued to ensure that children were placed in the most appropriate and cost effective placements.

There had been a number of favourable variances during the year totalling £375k. A favourable variance of £64k, was as a result of the introduction of the Vale, Valleys and Cardiff Adoption Collaborative which allowed the cohort of children placed for adoption within the financial year to be placed with adopters assessed within the Collaborative, which did not incur a charge. A favourable variance of £69k had been achieved through utilisation of grant income and £207k had been achieved by alternative means of provision and accommodation costs required for the current cohort of children, which was as a result of ongoing work to ensure that children were placed in the most appropriate and cost effective placements. A favourable variance in Resource Management and Safeguarding meant that there had been a reduced internal recharge of £35k to Children and Young People Services.

Adult Services – Adverse Variance of £22k

There were favourable variances in the year totalling £2.083m. There was a favourable variance of £774k relating to community care packages. While there was pressure on the budget during the year, additional grant income of £1.071m was received from Welsh Government, of which £369k was not advised until February 2018. A higher level of Continuing Health Care (CHC) income from Health was received than had been expected and additional funding was received from Welsh Government for respite care. During the year, there had been service remodelling, focusing on services which deliver reablement and supported people back into independence. Additional work had been carried out to mitigate increases such as schemes funded through the Intermediate Care Fund (ICF) and the year-end position was more favourable than projected.

Funding was also received from the Welsh Independent Living Fund. Welsh Government confirmed that any underspend against this grant was not required to be repaid and therefore resulted in a £179k favourable variance. This position had arisen as cases had transferred to the Council's responsibility as the scheme move to closure. There were favourable variances of £387k on staffing and £66k on supplies and services as, where possible, there was early implementation of future Reshaping Services savings. There had also been difficulty in recruiting to some posts which had been assumed would be filled in the months prior to year end. There was an over-recovery of income from customer receipts resulting in a favourable variance of £273k due to self-funding clients in Council run residential homes. Additional grant income was received of £100k which was awarded late in the financial year and utilisation of grant income resulted in an underspend of £229k. This grant income had to be assumed to be a one off benefit to the Council as it could not be guaranteed in future years. The favourable variance in Resource Management and Safeguarding had meant that there had been a reduced internal recharge of £75k to Adult Services.

The planned drawdown from reserves of £650k was not required however there had been a transfer to reserves of £1.455m, of which £1.285m had been set aside in the Social Services Legislative Changes reserve. If Welsh Government ceased grant funded initiatives, under the terms and conditions any redundancy costs could not be claimed against the grant and would need to be funded by the Authority, therefore, a Grant Exit Strategy reserve was established a number of years ago. The level of funding was reviewed for sufficiency annually and it was considered necessary to increase the level of the reserve by £170k. A transfer of £166k had been made into the Telecare Reserve which was an annual planned transfer in order to set funding aside for future years to replace the equipment and to cover any additional staffing costs.

Resource Management and Safeguarding – Favourable Variance of £4k

The majority of this budget was recharged to Children's and Adult Services. The position before recharges to services was a favourable variance of £233k. £106k had been achieved through the utilisation of grant income, £89k related to staffing and £38k due to a reduced recharge from the SWIFT consortium as a result of the implementation of the Welsh Community Care Information System (WCCIS).

There was an adverse variance on Deprivation of Liberty Safeguards (DOLS) of £58k. The favourable variance had meant that there had been a reduced internal recharge to Children's and Adult Services of £101k.

This had allowed a transfer of £70k to the Social Services Legislative Changes reserve.

Leisure – Favourable variance of £57k

There had been a number of adverse variances throughout the year totalling £365k. Supplies and Services budgets had an adverse variance of £342k mainly due to additional works undertaken for other departments plus additional schemes covered by grant funding within the Leisure and Play department. Transport budgets had an adverse variance of £23k.

These had been offset by favourable variances totalling £422k. Employees’ budgets had a favourable variance of £69k due to vacant posts within the service. Income from other departments had a favourable variance of £246k which offset the adverse variance on supplies and services above. There was also a favourable variance of £107k from additional government grants received during the financial year.

There was a planned transfer of £15k from the Council Building Fund for works to Leisure Centres.

Capital

Council, on 1^st March, 2017 (minute no. 863) agreed the Authority’s capital budget for 2017/18.

Attached at Appendix 2 to the report was a breakdown of the 2017/18 Capital Programme by scheme. The overall outturn for this Committee was a variance of £313k. Slippage of £357k was required.

Attached at Appendix 3 to the report was a schedule showing the Committee's reserves as at 31^st March, 2018.

Having considered the report, it was

RECOMMENDED – T H A T the provisional financial position and actions taken be noted.

Reason for recommendation

Having considered the accounts for the 2071/18 financial year.

133 REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1^ST APRIL TO 31^ST MAY 2018 (DSS) –

The Operational Manager – Accountancy presented the report, the purpose of which was to bring to the attention of the Scrutiny Committee the position in respect of revenue and capital expenditure for the period 1^st April to 31^st May, 2018 regarding those revenue and capital budgets which formed the Committee’s remit.

The Committee was advised that as it was very early in the financial year, the forecast for Social Services was shown as a balanced budget. However, there would be considerable pressure on this service in the coming year and this position may not be achieved.

The Revenue Budget shown in the table below includes the allocation of the Reshaping Tranche 3 Establishment Review savings which were held centrally as part of the Final Revenue Budget Proposals 2018/19 report which was approved by Cabinet on 19^th February, 2018.

variances
	Revenue Budget	Probable Outturn	Variance Favourable (+) Adverse (-)
	£000	£000	£000
Children and Young People	15,235	15,235	0
Adult Services	46,644	46,644	0
Resource Mgt & Safeguarding	201	201	0
Leisure Services	1,324	1,324	0
TOTAL	63,404	63,404	0

Children and Young People Services – The major issue concerning this service for the coming year would be the pressure on the children’s placements budget given the complexities of the children currently being supported. 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.

Adult Services – The major issue concerning this service for the coming year would continue to be the pressure on the Community Care Packages budget. This budget was extremely volatile and was influenced by legislative changes such as the National Living Wage. At this early stage of the year, the outturn position was difficult to predict. The service also continued to be affected by the pressures of continued demographic growth, an increase in the cost of service provision and the Community Care Packages budget would have to achieve further savings this year. The service would strive to manage growing demand and would develop savings initiatives 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.

Leisure Services – The Parks element of the revenue budget could no longer be reported separately, as operationally, it was an integrated part of the new Neighbourhood Services. It was therefore only possible to report the Leisure and Play element under this heading. As Parks capital schemes were separately identifiable they would continue to be reported to this Committee.

2018/19 Savings Targets

As part of the Final Revenue Budget Proposals for 2018/19, a savings target of £6.298m was set for the Authority. Attached at Appendix 1 to the report was a statement detailing all savings targets relating to this Committee.

Appendix 2 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.

Capital

Appendix 3 to the report detailed financial progress on the Capital Programme as at 31^st May, 2018.

Members should be aware that Appendix 3 included requests for unspent committed expenditure to be slipped from the 2017/18 Capital Programme into 2018/19 as approved by emergency powers on 12^th June, 2018.

Flying Start Family Centre – An emergency power was approved on 8^th June, 2018 to increase the 2018/19 budget by £6.5k, which would be funded by a Welsh Government grant. Whilst undertaking works to the Family Centre roof in 2017/18, it was found that the roof timbers had rotted. This grant would allow the replacement of the roof timbers to prevent further damage to the building.

Cartref Porthceri External Repairs – This scheme and the £25k budget allocated for 'External Ground works, Youth Offending and Cartref Porthceri buildings' were for drainage renewal. It had been requested that the budgets be amalgamated and the works could be procured together.

Hen Goleg Day Centre Fire Alarm – Quotations for the renewal of the fire alarm system had been received and were over budget by £3k. The Hen Goleg works scheme had £9k of uncommitted budget and it had been requested that £3k be vired from that scheme.

Hen Goleg Day Centre Lighting Upgrade – Quotations for the renewal of the emergency lighting had been received and were over budget by £6k. The Hen Goleg works scheme had £9k of uncommitted budget and it had been requested that £6k be vired from that scheme.

Leisure Centre Improvement – £200k of this budget was allocated to replace the Barry Leisure Centre Hall Floor. The commencement of the works to the hall floor were being put on hold until completion of the changing room upgrade to prevent damage to the new floor. The Barry and Penarth upgrade of changing rooms project had been delayed, with a completion now planned for March 2019. It had been requested that £180k be carried forward into the 2019/20 Capital Programme for the hall floor replacement.

Lougher Place Play Area – An emergency power was approved on 3^rd May, 2018 to include this £168k scheme into the Capital Programme (£2k in 2017/18 and £166k in 2018/19), to be funded from £126k Welsh Government Rural Development Programme Grant, £38.5k Section 106 monies and £3.5k contribution from the SAINTs charity in St. Athan. The scheme proposed sought to replace the existing play area at Lougher Place in St. Athan with the installation of a new multi-use games area.

The Committee noted the capital scheme in relation to the Leisure Centre Improvement Programme. The Committee raised concern that this programme had been delayed with the current completion date set for March 2019. In response to this, the Operational Manager Neighbourhood Services, Healthy Living and Performance stated that a report on this would be presented at the next Scrutiny Committee meeting. He advised Members that a contractor for the work had been found whose bid had come in under budget. He also advised that it was hoped that the work would be completed a few months before the March 2019 deadline. The Committee requested for an officer from Property to be present at the next Committee meeting when this item was being considered.

Subsequently, it was

RECOMMENDED –

(1) T H A T the position with regard to the 2018/19 revenue and capital monitoring be noted.

(2) T H A T progress made in delivering the Social Services Budget Programme be noted.

Reasons for recommendations

(1) To ensure that Members are aware of the position with regard to the 2018/19 revenue and capital monitoring relevant to this Scrutiny Committee.

(2) To make Members aware of the progress made to date on the Social Services Budget Programme.

134 OLDER PERSONS HOUSING AND ACCOMMODATION INCLUDING WITH CARE AND CARE READY (DSS) –

The Assistant Director – Integrating Health and Social Care presented the report, the purpose of which was to update Members on the assessment of older people’s housing and accommodation across the Vale of Glamorgan and Cardiff.

Part 9 of the Social Services and Well-being (Wales) Act 2014 required Regional Partnership Boards to agree an integrated Market Position Statement (MPS) and commissioning strategy for older people services. To meet this requirement, the Cardiff and Vale of Glamorgan Regional Partnership Board (CVGRPB) published its MPS in January 2018, following approval by the Vale of Glamorgan Council's Cabinet, Cardiff Council and Cardiff and Vale University Health Board.

In order to complete this work, the Housing Learning and Improvement Network (LIN) were commissioned by the Partnership to undertake a review, using funding provided by the Welsh Government's Integrated Care Fund. The final report was provided as Appendix 1 to the report.

The Assessment of Older Person’s Housing Accommodation reported that the proportion of the population over 75 years was expected to increase by 71% in the Vale of Glamorgan by 2035. This meant that the Council, working with housing partners and care providers, needed to consider the development of alternative types of accommodation which enabled people to live at home for as long as possible.

The research undertaken by Housing LIN sought to:

Provide a comprehensive understanding of the nature of current housing and accommodation provision for older people – including both social and private sector housing;
Identify the requirements and aspirations of older people in later life specifically in relation to housing and accommodation;
Identify the need for older people’s housing and accommodation, including different types of housing such as extra care housing, sheltered and retirement housing;
Set out a specification of the types of housing and accommodation that would meet the identified needs and requirements of older people.

The research also sought to identify current and future provision (where data allowed) for each of the three cluster areas in the Vale of Glamorgan: Central, Eastern and Western Vale.

In terms of current provision, the findings of the research revealed that in the Vale of Glamorgan the most prevalent type of older people's housing was sheltered housing (625 units) and other age designated housing (927 units) in the social rented sector. The current private retirement housing provision (204 units) also provided some mix of housing choices for different equity and income groups.

It was also reported that there was very limited extra care housing / housing with care provision in the Vale of Glamorgan (42 units) when compared with the prevalence of residential care beds (464 beds).

The research also highlighted a number of challenges regarding current housing in relation to a low proportion being wheelchair accessible and approximately 50% of older people schemes having a lift across Cardiff and Vale of Glamorgan.

In order to identify future requirements, Housing LIN modelled the provision of accommodation on the basis that the preferred approach by the Council would be to increase the number of extra care housing units as a direct alternative to the use of additional residential care beds. Similarly it was also assumed that partners would wish to increase the supply of Housing our Aging Population Panel for Innovation (HAPPI) inspired 'care ready' contemporary sheltered / retirement housing for older people which was suitable for ageing at home e.g. accessible living space, accessible kitchens and bathrooms to allow domiciliary care to be provided without necessitating a move to residential care.

Based on these assumptions, it was forecast that by 2035 the Vale of Glamorgan would require an additional 586 additional older person housing units, 385 housing with care units and 326 additional nursing care beds.

As part of the research, an online survey and a series of focus groups and interviews with older people were also undertaken across the Vale of Glamorgan and Cardiff. The engagement revealed a number of key messages to be taken into consideration for future development:

Adaptations to bathrooms; installation of grab rails; improving access such as ramps and installations of stair lifts / lifts were the most popular adaptations people had made or were planning to make to enable people to stay in their own homes;
The main reasons for planning a move from home was to live in a smaller and more accessible home; to move nearer to family and / or friends and to have access to care services;
The most popular locations in the Vale of Glamorgan that people wished to move to were Western Vale and Eastern Vale;
The most popular types of housing older people were seeking to move to were bungalows, followed by houses and then flats. 60% wanted at least two bedrooms in a property to consider downsizing. Other key factors were safety / security; having a private garden; adequate storage; having a garage or parking; moving to an area with cafes/shops;
Nearly half of respondents (47%) would not wish to move to housing designated for older people although 29% would consider this, with many wanting a visiting or on-site staff presence.

The Final Report (attached at Appendix 1 to the report) set out a number of recommendations for the Vale of Glamorgan Council and the wider Partnership to consider. These included:

Further development of contemporary 'care ready' sheltered / retirement housing which was without care on site but enabled people to age at home;
Mainstream housing developments to include well designed units which appealed to older people and which promoted inter-generational housing;
Increase the delivery of housing with care options including extra care and extra care 'lite' which may include smaller scale new build developments and redesigning some appropriate sheltered housing schemes to include a 'care hub';
Develop a comprehensive information and advice service for social housing tenants and homeowners in relation to adaptations and housing options;
Scale up the development of 'step-down' housing based models of care to support timely discharge and promote reablement;
To work with the Welsh Government in relation to affordable housing targets and the potential for guidance in relation to older people housing;
To work with care providers to consider alternative service models to residential care, including provision of nursing care.

Following completion of this research, the findings would be discussed further with the Vale of Glamorgan's Housing Forum and Care Provider Forums. The intention was that the report would also form an addendum to the Local Housing Market Assessment which would subsequently inform future planning policy.

As part of the wider partnership working across the region, the CVGRPB would also host a stakeholder event in the Autumn to encourage further discussion on joint working, including opportunities to align funding such as the Welsh Government's Integrated Care Fund.

A Committee Member thanked the officer for a very detailed report which emphasised how important it was for Social Services and Housing to work together. The Member also stated that the number of units required was high as was the cost, and so, the Committee Member was not sure how the aims of the programme would be achieved. In reply, Committee was advised that the challenge would be around the co-operation of all partners in order to achieve the set aims. This would include both public and private sector agencies.

A Committee Member referred to the projected 70% increase in people aged 75 and over. The Member stated that he felt that this was an understatement due to people making better lifestyle choices. The Member went on to ask whether there was any prospect of the Council introducing a 2% levy on Council Tax to cover community care services. The Cabinet Member for Healthy Living and Social Care, with permission to speak, stated that the current Administration would consider all options available in relation to the funding of Social Services. This would be considered as part of the budget setting process scheduled for later on in the year.

Subsequently, it was

RECOMMENDED –

(1) T H A T the contents of the report be noted.

(2) T H A T the minutes and the report be referred to the Homes and Safe Communities Scrutiny Committee for its consideration.

Reasons for recommendations

(1) Following consideration of the findings of the report and the projected increased demand for appropriate accommodation to meet the requirements of an ageing population with a growing prevalence of care and support needs.

(2) To ensure that appropriate scrutiny is exercised in this cross-cutting area.

135 RESHAPING SERVICES: A SUSTAINABLE APPROACH TO THE PROVISION OF SINGLE USER OUTDOOR SPORTS FACILITIES (REF) –

Cabinet, on 2^nd July, 2018, considered the report which brought to the attention of Cabinet the costs incurred in maintaining and providing sites and facilities that were predominantly for the benefit of single clubs and organisations. Cabinet had subsequently referred this issue on to the Scrutiny Committee for its consideration prior to final determination.

The Operational Manager for Neighbourhood Services, Healthy Living and Performance presented the report which indicated that there were a number of private sports clubs in the Vale of Glamorgan that provided outdoor sports provision and had active junior / youth sections but did not benefit from any direct subsidy from the Council. There were, however, a number of clubs / organisations that had almost exclusive use of some Council owned facilities. The manner in which the Council managed such assets did not reflect the need to ensure that budgets were used effectively. Notably, fees which were charged fell well short of covering the costs of operating these facilities.

Attached at Appendix A to the report was a breakdown of Council owned outdoor single use sport sites which were in the scope of the proposals.

The level of subsidies afforded to single use facilities varied depending upon the location and type of sport. However, for bowling greens, the level of subsidy was approximately £25k per annum. For large, fine turfed sports fields the costs to maintain and manage these facilities was approximately £80k per annum. The income from these facilities fell short of the cost to operate. This was estimated to result in a net cost to the Council of approximately £400k per annum.

It was therefore proposed that the Council would amend the fees charged to clubs and organisations for single use facilities from the current level to the actual cost of operating and maintaining these (after any income), from 1^st April, 2019.

It was proposed for the Council to initially make contact with the existing users of the facilities identified within Appendix A with details of the current costs of maintaining an operating these sites to be shared in order that the organisations and clubs are encouraged to explore the opportunity to take over the management of these facilities from 1^st April, 2019. This would be subject to agreement that ensured that they were maintained to a satisfactory condition.

Discussions would be undertaken on a facility by facility basis, reflecting the varying agreements currently in place and would also enable an Equality Impact Assessment to be developed which reflected the specific local circumstances of the facility.

In recognising that this would be a significant change, the Council’s preference was to provide clubs / organisations with the opportunity to maintain the facility themselves.

To assist clubs / organisations which wished to adopt this scenario, the Council was currently reviewing the Community Asset Transfer Protocol to enable a “fast track” process to be established that could assist with the transfer of responsibilities in this area as appropriate. In addition, signposting to organisations such as the Glamorgan Voluntary Service would take place in order to provide advice and support in the development of business cases for the running of facilities for potential sources of income.

It was also reported that it was likely, particularly for bowls, that the current level of single user provision at individual sites was unsustainable. Where it was clear, from initial meetings, that this was the case, the option of consolidation of facilities would be discussed with the clubs / organisations concerned so that they would be supported to bring new arrangements into effect.

Consultation would also be encouraged with Town and Community Councils and the Voluntary Sector, particularly where it was apparent that a single use sports facility may be unaffordable to the club / organisation currently occupying the site, or where the capacity and skills did not exist to allow that club or organisation to progress by way of a Community Asset Transfer or lease agreement. Such discussions would also likely include potential alternative approaches, including whether the Town / Community Council or another voluntary group could manage the facility or provide financial support to the club or organisation.

The Committee queried the possible transfer of assets at Corntown, with a Member advising that information on the costs had not been forthcoming from the Council. In reply, the Operational Manager stated that he was aware of this and the issue related to some of the site not being used since the 1990s.

A Committee Member asked why it appeared that fees had not increased for many years. In reply, the Operational Manager stated that fees had increased but there had not been a review of the costs associated to run each facility.

In reply to a query regarding progress around the transfer of Barry Athletics Club, the Operational Manager stated that it was unclear whether a full Community Asset Transfer was necessary in this case, and so, other possible options were being explored.

Discussion then ensued around the proposals and the following points were made:

The organisations and clubs in question were small in comparison, and so, would not always be willing to go through the Community Asset Transfer route. Faced with an increase in fees and with low capital, the Committee expressed concern of the support available in these scenarios;
Some Town and Community Councils had already applied for the transfer of facilities with proposals rejected by the Vale of Glamorgan Council. This had caused some Town and Community Councils to question the process and so were unwilling to partake in any further opportunities;
There was a need to be more specific around staff transferring to TUPE and also in regard to the impact on staff;
The Committee questioned the definition of a single use sports facility and Members provided examples where facilities were used by multiple organisations and had events held regularly;
There was a query regarding Rights of Way access;
The Committee was concerned with the lack of detail provided in respect of the costs and the use of each individual site and a request was made for more information to be gathered and presented to the Committee prior to any decision be made;
There was concern with the impact on mass participation sports such as rugby and football which in terms of player numbers were already facing significant pressures;
The facilities in question were community facilities that were of benefit to a number of people in the local population;
The Council’s proposals could make some of the facilities unaffordable;
The Committee requested that all possible avenues be explored with each individual organisation / club, which in the first instance should include consideration of fees;
There should be a detailed analysis on the impact of any possible increase in fees;
The Council should facilitate meetings with all clubs and organisations in order to gather their views of the proposals;
The Council should also look at why participation in some sports were dwindling.

In response to some of the points raised, the Operational Manager stated that the aim of the proposals were not to take away or change the ability of people to partake in sport or to make these facilities unaffordable. He assured the Committee that meetings would be held with all clubs / organisations in order to hear their views and to explore all options. He also agreed that there was not a clear definition around the use of single use sports facilities but this would be considered as part of contact with the clubs / organisations.

In summary, following consideration of the report, the Committee agreed that the proposals should be referred back to Cabinet asking for a further detailed analysis to be undertaken of all costs and use associated with the facilities, and for this to be reported back to the Committee. This further report should also include reference to the Council’s well-being objectives. The Committee also felt that it was vital for clubs / organisations to be contacted on a 1:1 basis in order to explore all other options beforehand and for more information to be presented on how the Council could support them.

Subsequently, it was

RECOMMENDED –

(1) T H A T Cabinet be advised of the Committee’s view that a more detailed cost base analysis should be undertaken for each individual site referred to in Appendix A.

(2) T H A T Cabinet be advised that detailed discussions should take place with each individual club / organisation in order to gather their views and also to understand what options were available.

(3) T H A T a further report on this matter to be presented to the Scrutiny Committee prior to any final determination.

Reasons for recommendations

(1) In order that a more detailed analysis of the associated costs be undertaken.

(2) In order that the views of each individual club / organisation is considered.

(3) In order for the Committee to consider the views of each individual club / organisation and also the costs associated with each individual site.

136 1^ST QUARTER SCRUTINY DECISION TRACKING OF RECOMMENDATIONS AND UPDATED WORK PROGRAMME SCHEDULE 2018/19 (MD) –

The Committee considered progress in relation to the Committee’s recommendations and confirmed the work programme schedule for 2018/19. Attached at Appendix A were recommendations in relation to the first quarter, April to June 2018, attached at Appendix B were recommendations in relation to the Municipal Year 2017/18 and Appendix C contained recommendations for the Municipal Year 2016/17. Attached at Appendix D was the updated work programme schedule for 2018/19.

The Democratic and Scrutiny Services Officer provided a verbal update in relation to decision tracking for 16^th April, 2018 and Minute No. 848 – Support for Carers in the Vale of Glamorgan, with it being recommended that the report be referred to the Learning and Culture Scrutiny Committee. It was noted that the Learning and Culture Scrutiny Committee considered this on 19^th June, 2018 and requested that a further report be presented in relation to the educational attainment of young carers. The Committee also noted that in regard to Minute No. 76 – Annual Report of the Director of Social Services, this was referred to Cabinet on 2^nd July, 2018, which noted the report. The Committee agreed that for both of these recommendations, the status could be changed to completed.

The Committee also agreed that in relation to Minute No. 681 from the meeting held on 16^th July, 2017, that following the update in relation to the development of a locality model of community mental health provision across the Vale of Glamorgan, that status in relation to this action could be changed to completed.

Subsequently, it was

RECOMMENDED –

(1) T H A T the updated work programme attached at Appendix D to the report be uploaded to the Council’s website.

(2) T H A T the following recommendations be deemed completed:

decision tracking
16 April 2018
Min. No. 848 – Support for Carers in the Vale of Glamorgan (DSS) – Recommended (2) That the report be referred to the Learning and Culture Scrutiny Committee to note the work in respect of young carers.	Referred to Learning and Culture Scrutiny Committee meeting on 19^th June, 2018 which recommended [1] That a future report be presented to the Committee in relation to the activities and steps that were being undertaken to assist young carers in the Vale of Glamorgan including their levels of educational attainment. [2] That the report requested in Recommendation (1) above, also include information on adult learners who were also carers. [3] That the support information developed by the Carers Trust South East Wales be circulated to all Chairs of Governors in the Vale of Glamorgan. Completed
15 May 2018
Min. No. 21 – “Your Choice” – A New Approach to Commissioning Outcome-Focused Care and Support at Home (DSS) – Recommended (3) That an update report on the “Your Choice” pilot be presented to the Committee six months after roll out.	Added to work programme schedule. Completed
Min. No. 22 – 4^th Quarter Scrutiny Decision Tracking of Recommendations and Work Programme Schedule 2018 /19 (MD) – Recommended (2) That the work programme schedule attached at Appendix D to the report be approved and uploaded to the Council’s website.	Work programme schedule uploaded to the Council’s website. Completed
12 June 2018
Min. No. 76 – Annual Report of the Director of Social Services 2017-2018 – Challenge Version (DSS) – Recommended (3) That the report be referred to Cabinet for consideration.	Referred to Cabinet meeting on 2^nd July, 2018, which noted the contents of the report. (Min No C348 refers) Completed
Min. No. 77 – The Vale Family Information Service – Annual Update (DSS) – Recommended (3) That the Committee receives an annual update on the Family Information Service.	Added to forward work programme schedule. Completed
16 January 2017
Min. No. 681 – Community Mental Health Services (DSS) – Recommended (2) That the report be referred to Cabinet to highlight the Committee’s grave concern regarding the condition and unsuitability of the Amy Evans building, which was clearly not fit for purpose.	Following the update in relation to the development of a locality model of community mental health provision across the Vale of Glamorgan, the Committee that status in relation to this action could be changed to completed. Completed

Reasons for recommendations

(1) For public information.

(2) To maintain effective tracking of the Committee’s recommendations.