Agenda and minutes

Social Care & Health Scrutiny Committee
Wednesday, 17th April, 2019 10.00 am

Venue: Chamber & Ante Room, 3 Spilman Street, Carmarthen, SA31 1LE. View directions

Contact: Emma Bryer  01267 224029

Items
No. Item

1.

APOLOGIES FOR ABSENCE

Minutes:

Apologies for absence were received from Councillors. A. Fox, G. R. Jones, B. A. L. Roberts and D. T. Williams.

2.

DECLARATIONS OF PERSONAL INTERESTS INCLUDING ANY PARTY WHIPS ISSUED IN RELATION TO ANY AGENDA ITEM.

Minutes:

Councillor

Minute No (s)

Nature of Interest

S.L Davies

Minute No. 4 – Services & Support for Children & Young People with Mental Health Issues.

Minute No 6 – Scrutiny Agenda Request – Prince Phillip Hospital Phlebotomy Service.

Works in the NHS

K. V Broom

Minute No. 4 – Services & Support for Children & Young People with Mental Health Issues.

Family member has autism.

 

There were no declarations of prohibited party whips.

3.

PUBLIC QUESTIONS (NONE RECEIVED)

Minutes:

The Chair advised that no public questions had been received.

4.

SERVICES AND SUPPORT FOR CHILDREN & YOUNG PEOPLE WITH MENTAL HEALTH ISSUES pdf icon PDF 174 KB

Additional documents:

Minutes:

[NOTE:  Councillors K.V. Broom and S.L Davies had earlier declared an interest in this item]

 

The Committee, in accordance with minute 5 of its meeting on the 5th March, 2018 along with the Education and Children Scrutiny (who were invited to attend item 4 of the minutes) considered a report that provided an overview of the existing services available for young people with emotional and mental health issues. 

 

The report also outlined plans to improve the coordination of services and support through a multi-agency forum.

 

The following questions / issues were raised on the report:-

 

·         The Committee raised concerns regarding the capacity to deal with the above issues.

 

The Committee was advised that collaborative working with specialist services and PRU would add capacity to support main stream schools. More efficient ways of working with specialist services had been looked at and also joint resilience project working in conjunction with the Leisure department.

 

·         Concern was expressed regarding the expectations of teachers to be social workers and advocacies.

 

The Committee was advised that therapy and education are different and that teachers were encouraged to build on existing skills such as communications and interactions with children. Supporting the wellbeing of teachers was a Welsh Government objective.

 

·         It was stated that poverty is also a big issue and that this can have a big impact on mental health. This had recently been compounded by the roll out of Universal Credit.

 

The Committee was advised that not all families were aware of what support was available and that an audit was being undertaken to enable the production of a global directory of services and support.

 

·         Officers were asked on the timescales between referral to assessment and could a school refer a child directly to Children Services?

 

It was stated that the Central Referrals Team conduct a triage and that urgent cases were attended to in a matter of days. The Head of Mental Health and Learning Disabilities advised that she would seek further clarification on referrals and time scales.

 

·         Concern was expressed that many schools were reporting zero incidents of bullying due to the current definition of bullying and that the County wide definition should be revised.

 

Advised that Welsh Government had consulted the Authority regarding the definition of bullying as part of its revised Anti Bullying Policy due for publication in June.  The Director of Education & Children’s Services advised that all schools have a policy that is relevant to them and that the policy was also inspected. He stated that he would challenge that there was no bullying in schools and stated that he welcomed the Welsh Government review.  It was also stated that a directory of services was included in the Wellbeing Strategy and that the directory could be widened.

 

·         Concern was expressed regarding the increase in substance misuse and the decrease in the age of children involved in substance misuse.  It was stated that the children were also dealt with using the same procedures used for adults and that this was  ...  view the full minutes text for item 4.

5.

ORDER OF BUSINESS

Minutes:

The Chair advised the Committee that, in accordance with Council Procedure Rule 2 (3) she was going to vary the order of business on the agenda to enable the Scrutiny Agenda Item Request – Prince Phillip Hospital Phlebotomy Service to be considered earlier in the meeting.

6.

CLLR R. EVANS - SCRUTINY AGENDA ITEM REQUEST - PRINCE PHILLIP HOSPITAL PHLEBOTOMY SERVICE pdf icon PDF 143 KB

Minutes:

[NOTE:  Councillor S.L Davies had earlier declared an interest in this item]

 

The Committee considered a request from Councillor R. Evans to add Prince Phillip Phlebotomy Service as an agenda item at a future meeting under Scrutiny Procedure Rule 10 (1).

 

Some of the concerns/observations raised by Cllr. Evans included:

·         The phlebotomy service was closing its doors early due to high demand for its service.

·         GP’s in the area are requesting tests for their patients instead of providing the service in-house.

·         Additionally, the Antioch Centre is under pressure and patients are having to wait up to 10 days for appointments.

·         Potential for patients to miss vital blood tests due to difficulties in attaining appointments.

 

The Committee was asked by Cllr. R. Evans to note that this had no reflection on the staff who provide a professional service.

 

UNANIMOUSLY RESOLVED that Neil Edwards, Head of Integrated Services raise the concerns with the Local Health Board using the formal process.

7.

REGIONAL ADVOCACY SERVICE pdf icon PDF 87 KB

Minutes:

The Committee, in accordance with minute 4 of its meeting on the 23rd January, 2019 considered a report providing information on the work that was underway to develop a co-produced regional advocacy service; the strategic and legislative background and context to this work. 

 

The report also provided detail of the engagement work that had been commissioned to support the development of a co-produced regional advocacy service.  Commissioners had gone out to tender for a pilot of the service in Ceredigion, the evaluation of which will inform the basis of a roll out of the regional service to Carmarthenshire and Pembrokeshire.

 

The following questions / issues were raised on the report:-

 

·         Clarification was sought on what self-advocacy meant.

 

Advised that self-advocacy was about empowering individuals – voicing control and representing oneself. For example Carmarthenshire People First support people to build confidence and to articulate for themselves.

 

·         It was stated that the concept of self-advocacy was a positive concept and consideration should be given to expand this.

 

Officers advised that this role will continue and that the NHS were partners to enable the maximisation of resources.

 

·         Question was asked if Carmarthenshire People First and Eiriol would remain independent.

 

The Committee was advised that this would be dependent on how the tender response was submitted.  Some of the Advocacy providers, including Eiriol, Pembrokeshire Peoples First & West Wales Mental Health Advocacy have already formed a new legal entity in anticipation of regional commissioning.

 

·         Question was asked how providers would agree who secures what contract.

 

In response, Officer advised that this was unknown territory and that the challenges were being worked through with providers. It was stated how important it was to keep local providers and expertise.

 

·         Concern was raised that people would miss out on early intervention and that a directory of available support should be available.

 

Officers agreed and stated that collaboration was key to early intervention.  The Committee was advised that children’s advocacy is under a separate contract that is already up and running (Mid & West Wales Advocacy) and that an all Wales directory of services was available in the form of ‘Dewis’, electronic directory portal.

 

·         It was asked how low key service providers would flourish under the new model.

 

Advised that the model would assist the smaller providers as a number of local providers don’t currently receive funding from the Authority. The revised model would bring them into the commissioning network.

 

UNANIMOUSLY resolved to receive the report

8.

REVENUE & CAPITAL BUDGET MONITORING REPORT 2018/19 pdf icon PDF 148 KB

Additional documents:

Minutes:

The Committee considered the Revenue and Capital Budget Monitoring Report in relation to the Social Care and Health Service, which provided an update on the latest budgetary position as at 31st December, 2018 in respect of the 2018/19 financial year.

 

The Social Care and Health Service was projecting and overspend of £930k on the revenue budget and a net variance of -£33K against the 2018/19 approved capital budget.

 

The following questions / observations were raised on the report:

 

Appendix B

 

·         Concern was raised regarding the vacant Social Worker post in TTTs Community Resource Team.

 

The Head of Mental health and Learning Disabilities advised that clarification regarding recruitment would be sought from Neil Edwards, Head of Integrated Services.

 

·         Clarification was sought regarding the vacant manager post within Adult Respite Care.

 

Advised that there had been an acting manager in place and recruitment of a permanent manager was in progress.

 

·         Question was asked why the Workchoice project had been decommissioned.

 

The Committee was advised that the project had been decommissioned as the wider project ceased due to not winning the tender (DWP). 

 

Appendix F (ii)

 

·         Question was asked why the data for Domiciliary Care (Fact File) was 3 years old.

 

Officer clarified that the data in the Fact File column was information from when the budget was set and was not routinely updated as part of the report.  Efficiency description is the information that is updated.

 

RESOLVED that the report be received.

 

Duration of Meeting

 

At 1:00 p.m. the Committee’s attention was drawn to Corporate Procedure Rule 9 “Duration of Meeting” and the fact that the meeting had been underway for three hours and it was

 

Resolved that Council Procedure Rules be suspended to allow the remaining items of business on the agenda to be considered.

9.

PERFORMANCE MONITORING REPORT - QUARTER 3 - 1ST APRIL TO 31ST DECEMBER 2018 pdf icon PDF 150 KB

Additional documents:

Minutes:

The Committee considered the Performance Monitoring Report for the period 1st April to 30th December 2018 (Quarter 3), which set out the progress against actions and measures in the New Corporate Strategy 2018-23 to deliver the 2018/19 Well-being Objectives relevant to the Committee’s remit, as at 31st December, 2018.

 

The following questions / observations were raised on the report:-

 

Off Target – Theme 10

·         Explanation was sought on what amounts to a DTOC (Delayed Transfers of Care) and how the figures were calculated.  Were the figures actual for the month/year or per 1000 of the population.

 

The Head of Mental Health and Learning Disabilities advised that the information would be confirmed by the Head of Integrated Services.

 

On Target – Action 13223

·         Question was asked if it would be possible to receive the outcome of the Quality Assurance Questionnaire on the provision of day opportunities for older people circulated to the Committee.

 

The Head of Homes and Safer Communities advised that he would arrange for the results of the questionnaire to be forwarded to the Committee.

 

On Target – Action 13234

·         Question was asked if a departmental dementia steering group had been set up.

 

The Committee was advised that this had been set up as part of the RPB (Regional Partnership Board).

 

On Target – Action 13226

Question was asked what other work in addition to the half marathon was being done.

 

The Committee was advised that there was collaboration between Health, Housing and Leisure around the ‘Healthier Wales’ strategy. The Committee agreed that a joint presentation would be useful.

 

RESOLVED that the report be received.

10.

CORPORATE STRATEGY 2018-23 - DRAFT UPDATE JUNE 2019 pdf icon PDF 216 KB

Additional documents:

Minutes:

The Committee considered sections of the draft update Corporate Strategy 2018-23 (June 2019) together with detailed delivery plans relevant to the remit of the Social Care & Health Scrutiny Committee.

 

·         Question was asked regarding the National Survey for Wales results 2016/17 (Agree there’s a good Social Care Service available) and where were Carmarthenshire now.

 

The Committee was advised that a recent survey demonstrates improvement on the 56.2% against the 56.8% average detailed in the 2016/17 survey.

 

UNANAMOUSLY resolved to recommend to the Executive Board that the draft updated Corporate Strategy 2018-23 be endorsed.

11.

SOCIAL CARE & HEALTH SCRUTINY COMMITTEE ACTIONS & REFERRALS UPDATE. pdf icon PDF 140 KB

Additional documents:

Minutes:

The Committee considered the update report detailing progress in relation to actions, requests and referrals emerging from previous meetings.

 

It was noted that several requests for updates had not been actioned.  The Committee asked that Officers address these as soon as possible. 

 

UNANAMOUSLY RESOLVED that the report be received.

12.

FORTHCOMING ITEMS pdf icon PDF 105 KB

Minutes:

The Committee considered the list of forthcoming items and agreed that the items should be presented to the next meeting.

 

The Head of Mental Health and Learning Disabilities advised that the item on Continuing Care / NHS Summit should be delayed as the Summit will not have taken place prior to the May Committee.

 

UNANAMOUSLY RESOLVED that subject to report on Continuing Care / NHS Summit being rescheduled for the Committee’s meeting on the 3rd July, 2019, the remaining list of forthcoming items be agreed and presented to the next meeting of the Committee to be held on the 20th May, 2019.

13.

TO SIGN AS A CORRECT RECORD THE MINUTES OF THE MEETING HELD ON THE 23RD JANUARY, 2019 pdf icon PDF 188 KB

Minutes:

UNANAMOUSLY RESOLVED that the minutes of the meeting of the Committee held on the 23rd January, 2019 be signed as a correct record.