SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)
Minutes of a meeting held on 7th March, 2016.
Present: Councillor R.L. Traherne (Chairman); Councillors R.J. Bertin, E. Hacker, H.C. Hamilton, Dr. I.J. Johnson, J.W. Thomas and Mrs. M.R. Wilkinson.
Also present: Councillor S.C. Egan.
903 APOLOGIES FOR ABSENCE –
These were received from Councillor Mrs. M.E.J. Birch (Vice-Chairman), Ms. R. Birch and S.T. Wiliam
904 MINUTES –
RECOMMENDED – T H A T the minutes of the meeting held on 1st February, 2016 be approved as a correct record.
905 DECLARATIONS OF INTEREST –
No declarations were received.
906 VALE OF GLAMORGAN COUNCIL ANNUAL SELF-ASSESSMENT (REF) –
Cabinet, on 8th February, 2016, had been provided with the strategic self-assessment of the Council’s performance for the period 2015-2016 that identified strengths, achievements, key challenges and areas for improvement.
Self-assessments formed 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 annual Council reporting framework for Social Services also required reporting annual on progress, outcomes and plans for improvement. This would build on the Council’s internal assessment of performance. Self-evaluation and reporting would also form the core element of Estyn’s Common Inspection Framework and annual self-evaluation.
The self-assessment report, detailed at Appendix 1 to the Cabinet report, demonstrated it was a refinement in the way annual performance was assessed. The report moved away from a focus solely on service performance to one that incorporated aspects of governance, resource management and collaborative working for the Council as a whole. It was intended that this provided a more balanced picture corporately of Council performance and the challenges being faced that would be used to inform future plans for improvement. The report was based on the key themes of the Wales Audit Office’s Annual Improvement Report: Performance Management, Governance, Resource Management and Collaboration and Partnerships. The report presented the strengths and the areas for improvement relative to each of these themes and the draw upon an internal assessment of performance data, the Council’s Annual Governance Statement, Internal Audit reports, the Annual Improvement Report issued by the Wales Audit Office, and reports by other external regulators and service based information. It also outlined the arrangements that were in place to support and identify any improvements in how the Council worked and delivered services. Evidence sources were provided for each theme to support the judgements made. This was detailed at Appendix D. A summary of the Council’s key achievements to date in relation to the Corporate Plan was also provided at Appendix C.
Appendix A of the report contained individual self-assessments for each of the Council’s Directorates. These provided an overview of performance over the past year against the 2015/16 Service Plans, which were written at a Directorate level. The self-assessments contained a brief position statement and performance overview. The self-assessment would then identify the key challenges, risks and priorities for services going forward into 2016/17.
The Chairman, in referring to Appendix A and page 4 which detailed the transfer of mental health services to Llandough Hospital and the financial impact of aftercare responsibilities under Section 117 of the Mental Health Act, queried the reasons for this. In response, the Head of Adult Services advised that there was a new duty for joint provision of care for those detained under the Act, which also related to people who were also classified as “homeless”. The Committee heard that responsibility for these individuals would depend on where they were detained and not based on where they lived. It would be difficult, therefore, for the service to anticipate correctly the number of people to whom this would apply. To meet this challenge, a joint approach was being undertaken across the Local Health Board, Cardiff Council and the Vale of Glamorgan Council.
A Committee Member commented that he had found this a very helpful document. It provided a broad idea of the challenges facing the Council and also it was useful to compare the Council’s performance to other Local Authorities in Wales. The Member then queried progress in relation to the new Welsh Community Care Information Solution (WCCIS), as detailed on pages 12 and 13 of Appendix A. In reply, the Director of Social Services advised that this would be implemented across Cardiff and the Vale of Glamorgan region as a whole (community health and social care) and that close working was taking place with I.C.T. as this was a corporate project. Welsh Government had allocated £6m in funding in order to procure hardware on an all-Wales basis to support implementation, which would be going live in Bridgend at the end of March. He added that all 22 Local Authorities and 7 Local Health Boards had made a commitment to procure the system. This meant that it was an exceptionally complex undertaking and the lead in time for completion would be longer. He also stated that in terms of progress to date he was optimistic and that he was also very positive about what the new system could achieve. It would mean that care practitioners could share information more easily and this would result in a more seamless service for clients. In relation to this query, the Chairman suggested that the Committee could discuss the case for a more detailed report on the WCCIS at the next Committee meeting, when the Committee’s future work programme would be presented.
RECOMMENDED – T H A T the contents of the Council's Annual Self-Assessment Report attached at Appendix 1 to the Cabinet report, including identified areas for improvement for 2016/17 onwards, be endorsed.
Reason for recommendation
To ensure that the relevant Scrutiny Committee confirms that the issues identified within the Self-Assessment were a fair reflection of the challenges facing both the Council as a whole and individual Service Directorates and that the information contained in the report was appropriate to inform service planning for 2016/17 onwards.
907 REVENUE AND CAPITAL MONITORING FOR THE PERIOD 1ST APRIL 2015 TO 31ST JANUARY 2016 (DSS) –
The Operational Manager – Accountancy presented the report, the purpose of which was to update Members on the position in respect of revenue and capital expenditure for the period 1st April 2015 to 31st January 2016.
The report outlined that the current forecast for Social Services at year end was an overspend of £100,000 which was the same as that reported the previous month. A graph and table setting out the variance between profiled budget and the actual expenditure to date and the projected position at year end was attached at Appendix 1 to the report.
In terms of Children and Young People’s Services, this service was anticipated to outturn £462,000 under budget at year end. The key issue for this service continued to be managing the demand for the Joint Budget for Residential Placements for Looked After Children. However, currently it was forecast to outturn with a £250,000 underspend at year end. There were other potential underspends elsewhere in Children’s Services of £65,000 on staffing budgets and £135,000 on alternative means of provision and accommodation costs required for the current cohort of children. In addition, the Business Management and Innovation Division was anticipated to underspend at year end and part of this variance would be apportioned to the Service area, therefore £12,000 of the underspend would be allocated to Children’s Services.
For Adult Services, it was currently anticipated to outturn £617,000 over budget at year end. This overspend was due to a projected overspend on Community Care Packages of £850,000 which was as a result of continuing demand for services, particularly for frail older clients. The annual deferred income budget for 2015/16 had been set at £739,000 and as at 31st January, 2016 income received to date was £141,000 under-recovered. It was currently projected that this budget would outturn at £100,000 over budget by year end and this adverse variance was included as part of the projected overspend for care packages. It was also anticipated that there would be underspends of £200,000 elsewhere in the budget which could offset part of the overspend with £165,000 from Staffing, £15,000 from Transport and £20,000 from Premises. In addition, the Business Management and Innovation Division was anticipated to underspend at year end and part of this variance would be apportioned to this area with £33,000 being allocated to Adult Services. As reported previously, discussions were ongoing with Health regarding the allocation of Intermediate Care Fund (ICF) funding to the Vale of Glamorgan Council.
With regard to Business Management and Innovation, this budget was anticipated to underspend at year end by £100,000 - £80,000 on Staffing and £20,000 on Transport.
For the 2015/16 budget programme, the report advised that the Directorate was currently required to find savings totalling £3.568m by the end of 2019/20 and at present there was a £186,000 budget surplus. The surplus and the savings brought forward figures were as a result of the Foster Carer Recruitment Project, which was being developed in addition to the required savings targets. This surplus could be used to mitigate any increase in savings to be found in future years.
In relation to the capital expenditure, Appendix 2 detailed financial progress on the Capital Programme as at 31st January, 2016. Appendix 3 provided non-financial information on capital construction schemes.
For the Cartref Porthceri Electrical Upgrade, a virement had been requested and had now been approved and orders would be placed by the end of February with works commencing in March. The work would extend into April as the property would still be occupied while works were being carried out and it would therefore be requested to carry forward £36,000 into the 2016/17 Capital Programme.
In terms of the Southway Electrical Upgrade, a virement had now been approved and orders would be placed by the end of February with works also commencing in March. The work would be extended into April as the property would still be occupied whilst works were being carried out and it would therefore be requested to carry forward £44,000 into the 2016/17 Capital Programme.
With regard to the Cartref Porthceri Subsidence project, this scheme had been delayed due to a number of staffing resource issues in Property Services which were currently being addressed. This scheme had now been programmed to take place in the new financial year for which it would be requested to carry forward £15,000 into the 2016/17 Capital Programme.
For the Rhoose Road Health and Safety Works, this scheme had also been delayed due to staffing resource issues in Property Services and the scheme would be taken forward into the new financial year, with a £24,000 carry forward into the 2016/17 Capital Programme.
In relation to the Social Services Lift Refurbishment project, orders had been placed for Ty Dyfan and Cartref Porthceri and works were anticipated to be completed by the end of the financial year. Works to the lift at Southway had been delayed due to issues regarding the fire proofing of the lift shaft which would need to be investigated before the scheme could commence. It would therefore be requested to carry forward £19,500 into the 2016/17 Capital Programme.
In terms of the new budget settlement for 2016/17, the Operational Manager – Accountancy advised the Committee that Cabinet had agreed to allocate an extra £2.2m in order to cover the cost pressures associated with Social Services. In addition, a savings target of £270,000 for the contract arrangements for domiciliary care had been pushed back from 2016/17 into 2017/18. Furthermore, it was proposed that the Council’s current projected revenue underspend of £492,000 would be transferred into the Social Services legislative changes reserve in order to fund short-term increased costs. Finally, the Directorate’s annual capital budget for asset renewal had been increased from £100,000 to £200,000 in 2016/17. In commenting on these changes, the Director of Social Services stated that previously the Scrutiny Committee had endorsed the Directorate’s calculations of a £4m increase due to cost pressures and he commented that these pressures had not gone away, but he was pleased to see the extra money allocated to the budget.
In referring to the £270,000 savings for domiciliary care packages, the Chairman queried how this would be achieved. In reply, the Director of Social Services stated that the service had been given an extra year to meet the savings target and this was part of the Reshaping Services project. He went on to advise that the Council had a commitment under the new Social Services and Well-being (Wales) Act to promote the development of social enterprises, co-operatives and third sector providers. This could help to bring greater diversity into the domiciliary care market but the service had found this to be a slow process and, to date, that there were not a large number of providers out there. The service was actively working with the Wales Co-operative Centre. He further stated that with respect to third sector providers, it was envisioned that they would directly reinvest surplus money back into their services. This could give some potential for savings, although it was not clear whether these would be on the scale required.
The Chairman also queried the number of capital projects for which completion had slipped into 2016/17. The Head of Adult Services advised Members that delays to these projects had been due to staffing resources issues within Property Services. The concerns of officers had been relayed to Property Services and both Services had agreed a plan in order to move the situation forward. Further to this, the Cabinet Member, with permission to speak, stated that there were genuine reasons for these delays and that he shared the concerns of the Scrutiny Committee which would be taken back to Cabinet. The Committee requested that an update be provided at the Committee meeting scheduled for the month of June. The Committee would wish to be advised of the confirmed completion dates for the slipped schemes and the confirmed completion dates for the 2016/17 schemes.
A Committee Member queried some of the savings projections that had a red or amber status. In response, the Director of Social Services highlighted that these represented high risk areas that would be difficult to achieve. The Member, with regard to the impact of the increase in National Insurance contributions and the National Minimum Wage / Living Wage, also queried where the £2.2m budget increase for cost pressures would be spent. The Director of Social Services advised that this extra money was intended primarily for legislative changes not for issues such as the National Minimum Wage, a consequence of new UK Government policy. He also stated that the service was in negotiations with providers over the fees that the service paid and this would include dialogue over the pressures being faced which needed to be backed up by actual evidence of the increased costs. He also alluded to the service pressures around the changing demographics, increasing demand and the changes to eligibility for services, some of which may also further increase demand.
In reply to a Member’s question regarding the use of the fund for changes to government legislation and legal challenges, the Director of Social Services informed the Committee that part of this money would be used to handle cost pressures such as those experienced following changes to Deprivation of Liberty Safeguards. However, he stated that the service had to be prudent in how this reserve was used and there was a recognised obligation to deliver services within budget.
The Chairman asked whether the market for care providers was robust enough, given the context of changes such as the new “living wage”. In answer to this, the Director of Social Services commented that this was a difficult dilemma and that it would not be prudent to allow providers to go out of business. He alluded to the symbiotic relationship that existed between the service and care providers and the need for supporting providers in their difficult work of providing quality care within a challenging financial climate.
A Committee Member commented on the excellent work that Flying Start had undertaken and the help that this project was providing to families in the community.
Having considered the report the Committee
(1) T H A T the position with regard to the 2015/16 revenue and capital monitoring be noted.
(2) T H A T the progress made in delivering the Social Services Budget Programme be noted.
(3) T H A T the report be referred to Cabinet for its consideration and to highlight the progress in delivering the Social Services Budget Programme.
Reasons for recommendations
(1) That Members are aware of the position with regard to the 2015/16 revenue and capital monitoring relevant to this Scrutiny Committee.
(2) That Members are aware of progress made to date on the Social Services Budget Programme.
(3) That Cabinet are kept informed of the progress made to date on the Social Services Budget Programme.
908 ASSISTIVE TECHNOLOGY AND DEMENTIA CARE TASK AND FINISH GROUP OF THE SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH) UPDATE REPORT (DSS) –
The Head of Adult Services presented the report, the purpose of which was to update Members of progress being made in delivering the action plan developed through the Assistive Technology Task and Finish Group.
The report advised that the Scrutiny Committee had set up the Task and Finish Group to examine the potential contribution that Assistive Technology could make in developing a Dementia supportive community in the Vale of Glamorgan and to enable people to live independently with a better quality of life.
During the course of the review, the Task and Finish Group was able to complete a thorough investigation and to make well considered recommendations for improving the responsiveness of the service. The Group recognised that further work was needed before major decisions could be taken in relation to longer-term planning.
The Group had concluded that Assistive Technology could be of considerable help to people experiencing dementia and also to their carers. However, national research, information from partners and data from existing services did not provide conclusive evidence that it was likely to deliver significant savings. Therefore, given the budgetary pressures that the Council faced, the Group made recommendations for improvements which it regarded were realistic and measured and it had identified that further work was required to develop the service for the future. The Group developed a detailed action plan in order to ensure that its recommendations were implemented and that progress could be measured.
The plan contained 15 action areas. An updated version was attached at Appendix 1 to the report. The progress made against each action indicated that the majority were either complete or had become of ongoing business.
Staffing arrangements within the small Telecare team were subject to ongoing review, to ensure that the service had a resilient and effective team model fit for future delivery. Some of the changes to date had limited the impact of the improvements made.
Throughout the period since the plan had been agreed, the numbers of people receiving Telecare had grown for users of both Tele V+ and Tele V; the prospects for further growth appeared positive. The full year estimates for Tele V was 247 packages provided through the year, compared with 240 in 2014/15. The full year estimate for Tele V+ was 84 packages provided throughout the year, compared with 69 in 2014/15. This performance did not meet the agreed targets for 2015/16 but there had been year-on-year improvement. The service had also developed four new local performance indicators from 2015/16 to help improve the understanding of the performance of the Telecare service.
In addition, the service had purchased equipment to support people with Dementia. This included bespoke decoration and two reminiscence pods for use initially at Rondel House day service. Tablet computers had been made available at care homes and the older people’s day service to support communication and provide additional activities. The report advised that the internet connection to support these devices was due to be put in place imminently.
The Chairman commented that one of his concerns was the resilience of the Telecare Service, given that it was a small team, and he asked whether there was a need to look again at the possibility of working on a regional basis or with health. In reply, the Head of Adult Services stated that at this stage, it was probably better to concentrate on how the service in the Vale operated and for this a lot of work was being undertaken. He stated that previously Cardiff Council had not been overly keen on a joint service, although Cardiff was not the only partnership body that the Vale could work with. Further to this point, a Committee Member commented that he agreed with the principle of working on a regional basis as there would not be the number of servicer users in the Vale of Glamorgan to make the service sustainable.
At this point, the Director Social Services stated that the review had been helpful in that it had clarified the direction for the service and provided a good ‘baseline’. He commented that the idea for working on a regional basis would not just be about achieving savings but as importantly about providing the very best service to service users. Further to the Director’s points, the Head of Adult Services added that it should be recognised that the service had improved its performance and although service resilience had been a challenge, the service had still managed to provide a safety net for its service users. He also alluded to market changes as a result of a popular pharmaceutical company deciding to provide Telecare packages and so the service model needed to be continually re-evaluated.
Furthermore, the Committee heard that it was difficult for the service to keep up with the rapid pace in technological developments, which was highlighted by the reduced need for GPS locators as most mobile phones now came with this technology. In terms of the service targets around the number of people that were supported, the Head of Adult Services advised that performance targets were reviewed each year. They would be based on progress and what the service thought it could achieve. He also advised that the setting of targets was not based on the amount of money that could be generated, but on the care needs of the service clients. The Committee was in agreement that an update report to be provided in six months’ time.
(1) T H A T the contents of the report be noted.
(2) T H A T the report be referred to Cabinet to highlight the progress being made in delivering the action plan developed through the Assistive Technology Task and Finish Group.
(3) T H A T a further update report be received in six months to indicate those actions which have been completed, to detail the future worked required and to highlight any issues around service resilience.
Reasons for recommendations
(1&2) To apprise Members and Cabinet of progress made to date.
(3) To apprise Members of the progress made in six months’ time.
909 UPDATE ON THE IMPLEMENTATION OF THE SOCIAL SERVICES AND WELL-BEING (WALES) ACT 2014 (DSS) –
The Social Services and Well-being (Wales) Act 2014 would come into force in April 2016. The Committee had therefore requested regular updates on the progress being made in readiness for implementing the requirements of the Act in the Vale of Glamorgan.
The report updated the information considered by the Committee in January 2016, which included:
- An update on the Information, Advice and Assistance (IAA) Service, especially in the area of Adult Services where the Council were building upon the positive work undertaken in integrating social care and NHS processes and staff alongside Contact One Vale.
- Information on the resources identified to secure a customised version of the national information portal, Dewis Cymru, for Cardiff and the Vale. Dewis can be found by following this link www.Dewis.Wales.
- The selection of our region by the Social Services Improvement Agency (SSIA) to pilot a new training course aimed at officers working at the First Point of Contact so that they fully understand the changes introduced by the Act.
- Progress of the four national work groups, established to share best practice and produce consistent material on an all-Wales basis.
- Information on the series of technical briefings for the Tranche 1 Codes of Practice. These were described as “gateway” documents that summarised the key points for each Code. Access to the briefings was again via the Care Council’s Communications Hub.
- An update on the national awareness raising campaign, led by Welsh Government, which started in February 2016. The Council’s Communications team would be assisting in dissemination of the key messages.
- Progress update on the workforce development materials being developed by the Care Council for Wales.
- The completion of the national training materials for the four core modules and the briefings for external trainers, to ensure that these materials were responsive to our needs.
- Confirmation that the Institute of Public Care at Oxford Brookes University would provide support for the new Regional Partnership Board, which would be established in accordance with statutory guidance under Part 9 of the Act, and deliver training on the implications of the Act for elected Members.
- An updated WLGA e- Bulletin.
The report advised that the four all-Wales work streams continued to meet. This region had sent officers to each of these groups so that the Council could contribute to develop national toolkits / checklists and, where possible, avoid duplication and to ensure that procedures / processes would fit within the local context. The national checklist outlining the common recording requirements for assessments had been completed and work continued on the development of the national checklist for the care and support plan.
The implementation team and change champions were finalising the amendments needed for the eligibility / assessment of needs processes in order to meet the requirements set out in the assessment national checklist. They were working with staff to update the Swift IT system so that information could be recorded electronically. Local updates would be delivered to staff in March to take them through these changes.
Using the national training materials, workforce development exercises had commenced to ensure that staff received an overview of the four key areas of change on a prioritised basis. External trainers had been brought in to work in partnership with the implementation team and the Local Authority change champions. However, not all staff would be trained by 6th April and training would continue until all relevant staff had been briefed. The service was therefore currently evaluating feedback on the training received to date.
The Directorate continued to work with the Social Services Improvement Agency to pilot a new training course which would equip officers working at the First Point of Contact with a full understanding of the changes to be introduced by the new Act. This included a focus on the “what matters” question in initial discussions with the people who contacted them. The first of the “Better Conversation” sessions took place in January with consolidation sessions taking place in February and March. Initial feedback had been positive and once the evaluation had been completed, the training would be rolled out to more staff.
The Institute of Public Care (IPC) at Oxford Brookes University had been appointed to deliver training for Elected Members on the implications of the Act. Invitations had been sent out for a session on 9th March. This session would also include an update on Corporate Safeguarding.
The report also stated that a public awareness campaign had been launched by the Health and Social Care Minister on 11th February. The Minister had also announced the membership of the National Independent Safeguarding Board which would advise him and work alongside the regional safeguarding boards (adults and children) to secure improvements in safeguarding policy and practice throughout Wales. The statutory framework introduced by the Social Services and Well-being (Wales) Act 2014 would require changes to “Working Together under the Children Act 2004” and “In Safe Hands” (which would guide the response to adult abuse and neglect). The report also stated that these were unlikely to be available for some time. In addition, some staff in the Council were obliged to follow the January 2013 version of the “Wales Interim Policy and Procedures for the Protection of Vulnerable Adults from Abuse” (POVA), which would also need to be updated to ensure compliance with the Act. Because times of significant change could generate increased risk for vulnerable people, it was important to have available clear guidance for all staff during such periods. Both regional safeguarding boards would be asked to confirm that the current guidance in respect of multi-agency and multi-professional policies and procedures would remain in force until any new material was agreed.
A local co-production workshop was held on 25th February with providers of advocacy services to explore how best an independent professional advocacy service for adults could be provided. The Directorate was in discussion with Welsh Government around how to develop a national approach to this issue similar to that being taken forward for children.
The Act also established a duty on Local Authorities and Local Health Boards to carry out a regional population needs assessment by March 2017. This would help to identify the range of preventative and wellbeing services currently available. The Cardiff and Vale Public Health Service would be co-ordinating this work and it was intended to use the Delivering Transformation Grant in 2016/17 to commission additional capacity to carry out this task.
In March, the Vale of Glamorgan Cabinet would receive a report which set out in detail the requirements of the Act and the changes needed. This report would highlight the fact that 6th April was another step on the journey towards full implementation of all the changes required. Much work would remain to be done thereafter, especially in reforming current services, revising current policies to ensure that they were compliant with the new statutory framework, and achieving the shifts in organisational culture needed.
The Chairman asked whether the Director of Social Services could comment on what he considered to be the main challenges. The Director stated that he was still perplexed by the notion of the Act being ‘cost neutral’ and he also mentioned the work to develop preventative services in order reduce service demand, the case for which was not yet convincing on a large scale. He also alluded to other significant challenges, such as the need for greater advocacy support, the “When I am ready” initiative and the requirement for extra support for carers.
In reference to the DEWIS Cymru wellbeing information website, a Committee Member queried whether the Directorate was happy with its content. In reply, the Director stated this was a positive development. At present, it was largely populated with resources relating to North Wales. In due course, this would be extended to cover the whole of Wales. He also added that this represented a monumental task, but progress was being made and that the information contained would need to be regularly updated.
A Committee Member queried whether the Act would represent a real change in culture. In response, the Director commented that this would be based on dialogue with the public around the need for individuals to take greater control and responsibility, coupled with the constraints in regard to resources. He also mentioned the importance for financial management within the Directorate and making the “money last”. He provided Members with reassurance that officers had a good understanding of “decision making” and that frontline staff understood the need to be prudent around budgets.
In answer to a Member’s request for an update around advocacy services, the Director of Social Services informed Members that advocacy was there to provide professional advocacy for adults with profound communication difficulties. Currently, not many voluntary and third sector advocacy agencies would have the required expertise to meet the needs of service users. Therefore, there was a need to develop a service and this would represent a significant cost pressure.
(1) T H A T the contents of the report be noted.
(2) T H A T the Committee continue to receive regular updates about the implementation of the Act.
(3) T H A T the report be referred to Cabinet in order to provide an update around the approach being taken to implement the Social Services and Well-being (Wales) Act 2014.
Reason for recommendations
(1-3) To ensure that Elected Members are kept informed about fundamental changes to the policy and legislative framework which underpins the work of Social Services.
910 QUARTER 3 SOCIAL SERVICES PERFORMANCE REPORT 2015-16 (DSS) –
The purpose of the report was to present performance results for Quarter 3, 1st April to 31st December, 2015-16.
The report stated that the Social Services Directorate was on track to achieving the objectives contributing to its service outcomes, with 86% of actions currently either completed or on track. 77% of the Corporate Plan actions were either completed or on track (of the nine Corporate Plan actions, one was complete, six actions were on track and two had slipped). There were six actions relating to the Improvement Objectives, of which five were on track and one had slipped. There were currently no Outcome Agreement actions.
Against Outcome 1, “People in the Vale of Glamorgan are able to request support and receive help in a timely manner”, in terms of ensuring a full exchange of information between Child Health and Disability team, the Continuing Health Care Transition policy had been completed, and clearer more timely arrangements were now in place for the University Health Board Assessment of the health needs and ongoing support of young people who met this criteria. The standing Transition Review Implementation Group was now more focused on those cases where there was dispute over Adult Social Services and the Group also now included representatives from Adult Mental Health Services (SS/A058).
As part of work to implement new service models to support individuals to access a wider range of inclusive opportunities, the Day Opportunities Strategy had been approved and work would continue around reviews of current day care arrangements being adjusted to facilitate work, training and leisure activities as part of universal services (SS/A059).
The multi-agency Families First and Flying Start Board had reviewed its meeting schedule and now met quarterly and termly to oversee the delivery of the programmes. All programmes were targeted with the intention of reducing longer term higher level statutory interventions. Board members were actively involved in the preparation for the implementation of the Social Services and Well-being (Wales) Act. The commissioned independent review of Families First projects and services was reaching a conclusion and would be reported back to the management board in February 2016. The review would seek to explore the programme’s ability to be fit for purpose and value for money. Flying Start continued to meet targets set within the 2015-16 delivery plan, including completion of the final rollout of expansion (SS/A007).
The report stated that slippage was reported for three actions under Outcome 1:
- The development of a wide range of options for older people requiring support and the preparation of a feasibility study for the provision of an older people’s village had slipped. A workshop had been held on 7th January, 2016 (SS/A010)
- Limited progress had been made during the quarter to increase the take up of assistive technologies such as Telecare. An additional post would be appointed and the current working arrangements were now being reviewed (SS/A011)
- The examination of how best to secure an increased range of service providers in social care, especially those who use a social entrepreneurial approach had slipped. A workshop had been held on 7th January, 2016 (SS/A015).
Against Outcome 2 “The Vale of Glamorgan Council protects vulnerable people and promotes their independence and social inclusion”, in terms of implementing and raising awareness of the Mental Health Capacity Act 2005 and the Deprivation of Liberty Safeguards remained high priority for the Directorate. The aim was to ensure that hospital discharges and the University Health Board choice policy were compliant with the requirements of the Mental Health Capacity Act through training and advice to relevant teams. No actions were reported slipped against Outcome 2.
Against Outcome 3, “Social Services in the Vale of Glamorgan review, plan, design and develop quality services that deliver best value for money to improve outcomes for individuals”, we have worked to complete the Cardiff and Vale Together for Mental Health Delivery Plan which had been forwarded to the Welsh Government, and the Directorate would continue to promote services that reduced stigmatisation and promoted mental health wellbeing.
Slippage was reported for one action under Outcome 3. This work was being undertaken on a regional basis, involving the Local Health Board and Cardiff Council, as part of steps towards joint commissioning. Council partners had found it difficult to commit to the strategy, but the approach had been redesigned. An Assistant Director, appointed recently by the three organisations, was implementing a work programme for fast tracking integration with included consideration of ways to introduce joint commissioning. Having a brokerage hub for residential care and nursing home placements would form part of this work. Until this issue was resolved, it was noted that this action should be deleted.
Of the 58 performance indicators that were measured quarterly, 38 (66%) had met or exceeded target, 10 (17%) were within 10% of target, and 9 (15%) had missed target by more than 10%. Data was not available for one (2%) measure. There were currently four Performance Indicators relating to the Improvement Objectives; two had met / exceeded target, one was within 10% of target and one had missed target by more than 10%. Of ten Outcome Agreement measures for this Directorate, seven had met / exceeded target, one was within 10% of target and two had missed target by more than 10% this quarter. The nine indicators that had missed target related to:
- SCA001: The number of delayed transfers of care for social care reasons per 1,000 population was 22 in the first quarter, 11 in the second quarter and 13 in the third quarter. Though this was a significant improvement, this was a cumulative indicator and the projected performance for the year was 5.34.
- SS/M004: Whilst the percentage of initial assessments that were completed during the year where there was evidence that the child had been seen by a worker missed target this quarter, it must be noted that there would be situations where it was not always appropriate for a child to be seen during the initial assessment. Therefore, performance was satisfactory in this context.
- SCC011b: The percentage of initial assessments that were completed during the year where there was evidence that the child has been seen alone by the social worker. Although this target was missed, there would be situations where it was not always appropriate for a child to be seen during the initial assessment. 60 children were seen alone at initial assessment by an SCO, Performance was satisfactory in this context.
- SS/M019a and SS/M019b: Both the rate per 1,000 of population of over 65s who have had a UA and OT assessment had missed target this quarter. Both indicators were local cumulative Indicators, the full year estimate for SS/M019a was 44.3. The full year estimate for SS/M019b was 26.82; this was a challenge to meet the target; due to the increase in population in 65+ years age group (additional 579 people).
- SS/M024: Although the percentage of reviews of child in need plans carried out in accordance with the statutory timetable had slipped this quarter, it does show an improvement in performance compared to quarters one and two. This indicator has been deleted from the Welsh Government returns for 2015-16, in preparation for the measuring of performance under the Social Services and Wellbeing Act. In 2015-16, the performance data was being monitored under local management information, not as a performance measure, and would be deleted from the framework in 2016-17.
- SS/M027: The average time taken to complete initial assessments that took longer than seven working days missed target for this quarter, four initial assessments had skewed performance due to families not engaging with Social Workers, had this not been the case performance would be 15 working days. This indicator had been deleted from the Welsh Government returns for 2015-16, in preparation for the measuring of performance under the Social Services and Well-being (Wales) Act. In 2015-16, the performance data was being monitored under local management information, not as a performance measure, and would be deleted from the framework in 2016-17.
- SS/M029: The average time taken to complete those required core assessment that took longer than 35 working days had missed target this quarter; one family, three children, were avoiding contact with Social Services this had delayed the completion of the Core Assessments. The Core Assessment took a total of 445 days to complete, had this not been the case the performance would have been an average performance of 60 delays. This indicator had been deleted from the Welsh Government returns for 2015-16, in preparation for the measuring of performance under the Social Services and Well-being (Wales) Act. In 2015-16, the performance data was being monitored under local management information, not as a performance measure, and would be deleted from the framework in 2016-17.
- SCC033: The percentage of initial child protection conferences due in the year which were held within ten working days of the initial child protection conference. The out of timescale initial core group meetings in quarter 3 were completed one day out of timescale. This indicator had been deleted from the Welsh Government returns for 2015-16, in preparation for the measuring of performance under the Social Services and Well-being (Wales) Act. In 2015-16, the performance data was being monitored under local management information, not as a performance measure, and would be deleted from the framework in 2016-17.
In referring to actions SS/A010 and SS/A015, which were detailed on page 11 of the appendix, the Chairman queried whether these may be a bit ambitious. In reply, the Committee was advised that these were challenging. However, because they were long term projects, these actions may be revised as the situation developed.
Furthermore, and in relation to action SS/A010 and plans to develop a wide range of options for older people requiring support and the provision of an older people’s village, the Cabinet Member stated that a workshop around this had gone very well and it was hoped that a report on options would be presented to Cabinet very shortly.
With regard to action SS/A043 relating to the development of a brokerage hub for residential and nursing home placements, the Director of Social Services advised that this was challenging as it involved three regional organisations that had different approaches to making placements. Therefore, the aim was to increase the choice for people and to allow them to make an informed choice.
The Chairman, queried performance indicator SCA001, relating to the number of delayed transfers of care. In response, the Head of Adult Services explained that in January, the hospital discharge for two individuals had been delayed as a result of social care reasons. He highlighted to Members that one of the main reasons for delays had to do with reaching an agreement with families and the service user around the choice of placement offered. This would mean that a person had been assessed but placement arrangements had not been made. He also stated that this represented a group of individuals, some of whom would be the responsibility of Health and some would be the responsibility of Social Services. The Committee was also informed that a part of the Intermediate Care Fund had been used to recruit a third sector Placement Advisor to work with this group.
A Committee Member requested an update with regard to action SS/A055b (to consider options for the delivery of long term care to address any shortfall in independent sector provision, particularly in relation to people with dementia-related illnesses). The Head of Adult Services stated that this related to a thematic review into dementia care undertaken by the Care and Social Services Inspectorate for Wales. Specifically, this related to work being undertaken to improve Rondel House.
The Head of Children and Young People Services, in answer to a query regarding those performance indicators that were marked for deletion, advised that there was to be a new national framework for measuring performance. Some indicators would stay the same while some would change, such as those which would be re-focused on preventative services. She also stated that some indicators would continue to be monitored for management information purposes. Once the new performance framework had been agreed, this would be shared with Members.
(1) T H A T the service performance results and remedial actions taken to address service underperformance be noted.
(2) T H A T the progress to date in achieving key outcomes as outlined the Corporate Plan 2013-17, the Outcome Agreement 2013-16 and the Improvement Plan Part 1 2015-16 be noted.
Reasons for recommendations
(1) To ensure the Council is effectively assessing its performance in line with the requirement to secure continuous improvement outlined in the Local Government Measure (Wales) 2009.
(2) To consider the Quarter 3 Social Services performance results as at 31st December, 2015 in order to identify service areas for improvement.