Agenda Item No 8
The Vale of Glamorgan Council
Healthy Living and Social Care Scrutiny Committee: 12th September, 2016
Report of the Director of Social Services
Service User and Carer Consultation - 2015 Outcomes and 2016 Plans
Purpose of the Report
- To ensure that Elected Members are provided with an overview of the ongoing service user and carer engagement activity within Social Services.
That Scrutiny Committee:
- Notes the Service User and Carer Consultation Report.
- Continues to receive information about the annual programme of consultation activity.
Reasons for the Recommendations
- To provide Elected Members with information about engagement and consultation activity with service users and carers.
- To ensure effective scrutiny of a key function undertaken by Social Services on behalf of the Council.
- The Policy and Quality Assurance Officer for Social Services undertakes an annual programme of consultation from January to December, to explore the experiences and views of service users and their families. The themes of the consultation are underpinned by service priorities as confirmed by senior management at the start of the year. These priorities are derived from the findings from audit, inspection and other quality assurance processes.
- A three year consultation plan is developed with Operational Managers and Heads of Service and it allows sufficient flexibility to respond to emerging needs.
Relevant Issues and Options
- The plan schedules annual consultations which must take place if we are to comply with the requirements for providing regulated service activity (e.g. fostering, adoption, residential care, adult placement and respite services). Other consultation is arranged as required according to the needs of service areas and the outcomes of inspection, audit and other quality assurance activity including complaints.
- The methodology for consultation activity is developed in partnership between the Policy and Quality Assurance Officer and team managers/operational managers. Questionnaires are the most frequently used method but semi-structured interviews are increasingly employed, particularly in settings where many service users might be in attendance. In addition, service users are provided with a range of options for engagement including telephone interview, postal return and face to face interview. Questionnaires based on symbols are also developed for people who require them in this format. Questionnaires can also be developed in alternative languages if required.
- Attempts are made to contact as many service users as possible where appropriate. In most service areas, this will be at least half of the user population. In all circumstances, a representative sample will be sought. Response rates have been above average in many areas. However ,in other areas where it may be more difficult to engage service users, the rate has not necessarily been representative of the service user population. This is always acknowledged in the resulting report and recommendations are made to improve rates for future consultation.
- As potential improvements to consultation processes are identified, we act to achieve them. This year, we have identified the need to improve the quality of response to questionnaires, leading to a better understanding of the service user experience and ultimately changes to service provision that provide improved outcomes. In response to this, questionnaires have been expanded to ask more specific questions about information received by service users. Also, newer service users have been engaged in the consultation to obtain a more recent overview of the information they received.
- During 2015-16, we consulted on the levels of satisfaction with support and information received while receiving the following services:
- Adoption Service: Satisfaction with processes and support surrounding recruitment, training, matching, placement and review within the adoption process.
- Advocacy for Children and Young People.
- Flying Start.
- Protection of Vulnerable Adults.
- Respite for Adults with a Learning Disability.
- Youth Offending Service: Management Board.
- Contact One Vale: Effectiveness of the signposting and information provided by C1V. This is part of a rolling programme and new service users are identified each month.
- Adult Placement Service: satisfaction with the referral process, matching, and placement.
- Meals on Wheels: satisfaction with information provision, timing of meals, and staff.
- Residential Services: Satisfaction with moving into the residential home, the living arrangements and the general management within the residential service.
- A report is produced for each consultation and an action plan is developed to address areas identified for improvement. To ensure that learning from one area is translated into improvements across the Directorate, issues are also collated thematically.
- Overview of the 2015/16 thematic learning:
Information provided before the start of the service.
- Information provision was of a good quality, and adopters found home visits very useful. People felt that they had received enough information to make informed decisions. People appreciated ongoing communication throughout the process. There were very positive comments about the contact with social workers and the support they provided as well as some improvements being suggested.
- Verbal information provided by the service provided a clear understanding of what the service can help them with and was often a preferred method. Nearly all respondents said they received information about the service at the right time in their involvement with the service, for example to make an informed decision about moving into a residential home.
- Although most felt they knew enough about the service, some felt they did not have any information at all.
- Where information was required in Welsh or in an alternative format (e.g. larger print), this was provided in most cases.
- Recommendations for future provision of information were sent to the relevant managers to ensure that information is timely, relevant, helpful and sufficient.
Services and Support:
- Overall, service users and their families/carers are satisfied with many aspects of the care that service users receive across the service. Very positive feedback was provided about social worker support, particularly the psychological and emotional aspects of sensitive processes such as adoption and fostering.
- For service areas that provided matching and placements, there was very high level of satisfaction with the identification of a suitable match. Service users were also very satisfied with where they lived and felt welcome when they moved in.
- Many people felt that the support they have received has met their expectations, although young people appreciate having one social worker who remains consistent.
- A high number of respondents for the domiciliary care services found them reliable, with courteous and polite staff and many were satisfied with the timings of the service (e.g. delivery of meals, care provision times).
- Respondents felt that service users are encouraged to maintain skills and independence where possible. In most cases, opportunities are provided for a social life and service users have a good degree of choice in routine, nutrition and activity. Service users said they feel safe and needs are generally well catered for, although some relatives perceived short staffing as an issue in some of the Council's own residential homes.
- Carers/relatives commented about how well looked after they feel across social services settings. They feel that there is a warm and caring atmosphere in the Council's own homes and that residents are safe and cared for.
- Most of the carers/relatives who responded said they and the service user were given enough information about services before the service commenced. They also feel that staff listen if they need to talk to them about any concerns.
- Many carers felt that their views as a carer/relative have been taken into account during the service provision that they and the service user have received.
Complaints and Compliments:
- Many people have never felt the need to make a complaint about the service they or their relative has received. Of those who did, most felt the process had been considered appropriately by the service, concluding with an acceptable resolution.
- Complaints information must consistently be provided to service users and their families as some people are still reporting that they are not receiving documentation.
- What was learned?
Good Practice Identified
- In general, information provided to service users and their families has been user-friendly and sufficient for their needs. Where further information has been required, it has been obtained and in a timely manner. Staff regularly update relatives and give reassurance about the service users' wellbeing. Across the service, it was reported that service users are made to feel welcome when they first attend our facilities.
- Overall, the Social Services department has supported carers/relatives to consider the options and choices available to them in their role as a carer. In addition, carers feel that the service users are listened to and well cared for in many service areas. This reassures them and reduces their concerns about their friend or relative.
- Service users often have opportunities to give their views, for example in Residential Services, Day Services and Respite at regular service user meetings.
- Staff across Social Services are generally very highly regarded, particularly with respect to support provided and their manner and attitude towards service users and their relatives/unpaid carers.
- It was suggested that some service users would be able to understand information more if it was provided verbally, for example someone providing general advice about advocacy. Other information could also be provided to young people through texts or flyers.
- Most of the young people feel listened to. However, some feel frustrated and not as involved as they would like in decision-making with their social worker.
- There are some improvements to be made to the introductions process for young people when transferring to a new social worker, for example having a set meeting with their previous and new social worker together so that it is more consistent and any concerns the young person has can be allayed.
- Many carers identified the need for more staff to prevent issues such as delays which could be potentially detrimental to service users. Also, more staff contact was recommended in domiciliary care, day and residential services so that the service users can interact with them and reduce social isolation.
- Having more choice of activities was mentioned as an improvement across Social Services. Relatives/Carers of service users in the Respite service and Residential service felt that that the service users do not go on as many outings/trips as they used to, although service users reported being quite satisfied with the opportunities available in these service areas.
- Others felt that the appearance of some of the Council buildings was poor and could do with improvement, for example paintwork and furniture appeared out of date and required upkeep.
- Response rates could be improved through interviewing more service users and carers, particularly young people.
- Service changes as a consequence of receiving stakeholder feedback include having more regular service user meetings at residential homes and at day service settings to establish what service users would like in terms of improvements. Tangible feedback and improvement processes are in place which the consultation process can ensure are taking place.
- In the Respite service, service users have become more involved in choosing ingredients for the meals, shopping for the ingredients and preparing the food (where appropriate). Activities are taking place that the service users have mentioned they would enjoy (for example trips and playing games). Staff take more time to sit with service users which they appreciate, although this was mentioned as an improvement by carers/relatives.
- There have been extensive developments to the Rondel House Day Centre. It has been redecorated with past scenes of the local areas in the Vale of Glamorgan. Service users have noted what an improvement this is and that they feel the centre is more welcoming and attractive. It feels welcoming and reassuring. This is particularly the case where service users have memory problems.
- More interviews are being conducted (as it has been recognised that this encourages feedback from more vulnerable service users and young persons). Sessions where the Policy and Quality Assurance Officer is available to hold face to face interviews are now taking place at Social Services setting to ensure all service users have an opportunity to give feedback in a confidential environment. This will continue in future years to ensure that this opportunity continues.
- Opportunities to visit settings have taken place for a number of years; however this is taking place as a matter of course as it was identified as a positive aspect. Tea visits and overnight visits continue to take place at the Respite Service, and relatives/families can bring potential residents to the Residential home to have a look and have an opportunity to ask questions to staff and managers.
Impact of the Social Services and Wellbeing (Wales) Act 2014
With the implementation of the Act, consultation areas have developed to incorporate more of a focus on outcomes for service users and their families. We are exploring service users' experiences of choice, whether their needs are addressed through service provision and whether they feel they are sufficiently involved in both the assessment process and care planning.
We are looking more closely at the provision of information, advice and assistance, and how this has helped citizens who have made contact with the service. Questions have therefore been developed to incorporate these areas and the outcomes they have had.
- Risks to the 3 year consultation plan/activity;
Consultation with citizens runs on a three year priority plan, which has recently been updated to incorporate new requirements for 2016-18 (Appendix 1). In 2016, the introduction of the SSWBA means that we will be carrying out additional consultation activity to respond to requirements from the Welsh Government. Pre-determined questionnaires (developed by the Welsh Government) are to be sent to a sample of adult service users with a care and support plan and all children who are involved with social services to obtain satisfaction levels with their involvement. Currently the priorities are identified in January of each year and themes are identified internally, however the requirements of the Act mean that we must focus on service specific questions, rather than the general themes that the questionnaires for the Act will address.
Timing of consultation will have to incorporate the requirements of the Act. The implications of this are that consultation priorities identified by senior management for the three year priority plan will be carried out from January to August. Care will be taken to ensure that people who are consulted with are not sent additional questionnaires and risk consultation fatigue.
We will continue to identify key areas to carry out specific consultation projects to support the existing process and the priorities for consultation will continue to be reviewed annually. All services that are registered and inspected (please refer to the list below) will therefore remain a consultation priority in addition to the qualitative measures required by the Act:
- Residential Service
- Adult Placement Service
- Respite Service
- Fostering Service
- Adoption Consortium
- Carers (support and assessment - questionnaires incorporated into each service area).
- Looked After Children
A copy of the current 3 year consultation priority plan (2016-2018) is attached as an appendix. This has been updated in line with the arrangements for changes as part of the Social Services and Wellbeing (Wales) Act 2014.
Resource Implications (Financial and Employment)
- Consultation activity is carried out within existing resources. Where consultation is being carried out in other directorates or through existing mechanisms (e.g. panels or fora), consultation for Social Services is carried out in conjunction if appropriate. Consultation and engagement for the requirements of the Social Services and Wellbeing Act is being carried out by Public Health however the Policy and Quality Assurance Officer for Social Services is providing support and is on the Steering Group so that any work is not duplicated.
Sustainability and Climate Change Implications
- There are no sustainability and climate change implications arising directly from this report.
Legal Implications (to Include Human Rights Implications)
- There is a requirement for local authorities to consult with service users in the delivery of regulated social services.
Crime and Disorder Implications
- There are no crime and disorder implications arising directly from this report.
Equal Opportunities Implications (to include Welsh Language issues)
- The Local Authority is required to comply with its duty under Section 149 of the Equality Act 2010. Section 149 requires a Public Body when carrying out all of its functions to give due regard to the need to limit discrimination, advance equality of opportunity and foster good relations in respect of the protected characteristics of age, disability, gender, gender reassignment, pregnancy and maternity, race, religion or belief and sexual orientation.
- Consultation activity is designed to promote equality of opportunity and ensure that service users and carers are able to respond according to their ability and preferred method.
- Citizens of the Vale of Glamorgan can easily access efficiently managed services that are focused around their needs, have confidence in how decisions are made and are proud to live in the Vale.
Policy Framework and Budget
- The report is in accordance with the Council's policy framework and budget.
Consultation (including Ward Member Consultation)
Relevant Scrutiny Committee
- Healthy Living and Social Care
Suzanne Clifton, Interim Head of Service, Business Management and Innovation
Laura Eddins - Policy and Quality Assurance Officer, Social Services
Alys Jones - Operational Manager, Safeguarding and Performance
Philip Evans, Director of Social Services