Agenda and minutes

Apologies were received from Councillors T.T. Defis, W.T. Evans, H.I. Jones, E. Morgan and J. Williams.

The Chair noted that Councillor J. Williams had recently been in hospital but was now at home and on behalf of the Committee, wished her a speedy recovery.

There were no declarations of prohibited party whips.

The Chair noted that no public questions had been received.

In response to a query as to whether a public question would be read out if the questioner was not present, the Chair suggested that as at County Council meetings, the individual posing the question would be expected to attend to ask their question but that she would clarify this.

The Committee RESOLVED that the list of forthcoming items to be considered at its next meeting scheduled for the 14th December 2015, be endorsed. 

Councillor K. Madge declared a personal interest in that his wife is a sister at Amman Valley Hospital.

Councillor B.A.L. Roberts declared a personal interest in that her daughter owns a shop in a local hospital.

The Chair welcomed Mrs. Linda Williams, the County Director & Commissioner of Hywel Dda University Health Board and Dr. Michael Thomas, Consultant in Public Health at Public Health Wales to the meeting. 

The Committee received a presentation on the Carmarthenshire Foundations 4 Change, an English performance assurance model being piloted in Wales by the Hywel Dda Health Board.

The following issues were raised in relation to the presentation:

In response to a question regarding the Bronze level Investors in Carers for GP practices, the County Director & Commissioner confirmed that all GP practices in Carmarthenshire had achieved this level but work was still on-going to ensure that all practices reached the Silver level by April 2016.

It was asked why and English model had been used rather than a home-grown solution to the unique needs of the health service in Wales and how its aims could be achieved when certain parts of the service were ‘broken’ and there was significant difficulty in attracting key workers to West Wales. The Consultant in Public Health and the County Director & Commissioner noted that regardless of its origin, the key aims of the model were aspirations that everyone would wish to sign up to and seek to emulate. The County Director & Commissioner acknowledged that recruitment for the Hywel Dda region was difficult and this was a key issue that the Board was seeking to address. However, she stressed that Carmarthenshire was better placed than other counties in the region, particularly due to the teaching hospitals and collaboration with the Swansea University Medical School.

In response to a query about life expectancy in Carmarthenshire and the increased number of older people, the Consultant in Public Health confirmed that the aim was to increase life expectancy by 3 years across all age groups as well as the areas with the lowest life expectancy. Following an additional question regarding the most deprived areas in Carmarthenshire in terms of health inequalities, the Consultant in Public Health acknowledged that life expectancy for those areas would be lower but that health services were being targeted there to address the problems (e.g. smoking cessation, Iechyd Da).

Concern was expressed that younger people were continuing to consume significantly higher levels of alcohol than previous generations and it was asked what could be done to address this. The Consultant in Public Health informed the Committee that much work was undertaken within educational establishments (e.g. Carmarthenshire Healthy Schools Scheme and Iechyd Da Youth Programme) and that individuals admitted to Accident & Emergency Units as a result from excessive alcohol consumption were signposted for diagnosis and treatment via an alcohol liaison nurse. 

Reference was made to the number of armed forces veterans returning from active service and it was asked what GP practices were or could be doing to assist ex-servicemen and  ...  view the full minutes text for item 6.

Councillor K. Madge declared a personal interest in that his daughter works in Social Care Services.

The Committee considered the Annual Report on Adult Safeguarding for the 2014/15 financial year. The Committee also received a short presentation which gave an overview of the purpose and context of the annual report. The report outlined the national policy context of adult safeguarding including the likely implications of the Social Services & Well-Being Act 2014.

The following issues were raised in relation to the report:

Whilst the many positive developments and activities highlighted by the report were welcomed, concern was expressed at the apparent lack of prosecutions brought against individuals alleged to be responsible for abuse. The Safeguarding & Commissioning Manager acknowledged that officers shared members’ concerns and frustrations but that cases of abuse were often complex and difficult to obtain the necessary evidence to take individuals to court, especially when cases involved adults with limited or impaired capacity to understand the situation, or being unwilling to go to court at all. He added that current legislation did not help officers in their task but hoped that the recent Flynn Report (In Search of Accountability), a review of the neglect of older people living in care homes undertaken for the Welsh Government, would lead to a change in legislation and close this gap. The Director of Community Services noted that when setting thresholds for prosecutions, it was not always in the best interest of the individuals concerned to prosecute. However, he added that where there was clear evidence of pre-meditated intention to harm or abuse, members should be reassured the Authority would advocate for prosecution although this was a matter for the police and the Criminal Prosecution Service.

The Executive Board Member for Social Care & Health informed the Committee of a research project was being undertaken by Carmarthenshire County Council in conjunction with Cardiff Council and Aberystwyth University. The aim of the research was to raise awareness amongst individuals in or receiving care of the options open to them if they felt subjected to any kind of abuse. The research was also aimed at examining the reasons as to why individuals did not wish to pursue prosecutions and the potential role of a ‘broker’ to mediate between the respective parties in order to reach an acceptable outcome. 

Reference was made to the significant increase in the number of referrals received in 2014/15 and it was asked whether this was a one-off or was it as a result of the Authority’s improved procedures. The Safeguarding & Commissioning Manager noted that it was difficult to state what the exact reason for the increase had been but that the increase in the attention and publicity given to all kinds of abuse as well as an increase in engagement and better training, may have all contributed to the increase in referrals. He added that in some ways, it was encouraging that individuals felt able to report incidents of abuse and that this might be a mirroring of that which had  ...  view the full minutes text for item 7.

Councillor K. Madge declared a personal interest in that his daughter works in Social Care Services.

Councillor G. Thomas declared a personal interest in that her husband is a driver for Country Cars.

The Committee considered the draft Local Ageing Well Plan for Carmarthenshire which had been developed to meet two key strategic drivers; the Ageing Well in Wales programme with five themes and the Strategy for Older People in Wales. The Plan linked with the ‘Vision for Sustainable Services for Older People’, under development within the Communities Department. It also supported the 2015 Well-Being of Future Generations Act, through contributing towards sustainable communities that enable people to age ‘in-place’.

The following issues were raised during consideration of the report:

Reference was made to the financial implications attached to the report which indicated that the Plan would be cost-neutral and an explanation for this was sought from officers. The Policy, Consultation & Engagement Officer and the Director of Community Services informed the Committee that the Plan was considered to be neutral in the sense that there was no specific part of the document that requested funding and that it was an opportunity to bring different agendas and Authority initiatives together by utilising the services already in existence. 

The Executive Board Member for Housing (and Older People / 50+ Champion) suggested that in light of the increasing numbers of older people in the County, the Plan was an opportunity to invest to save by providing older residents with the relevant information in a timely manner and communities with guidance on what they could do to help with this agenda. The Executive Board Member for Social Care & Health (and Older People / 50+ Champion) added that the draft Plan was a holistic strategy and that it was not just about creating a dementia or falls-friendly communities but all-encompassing supportive and resilient communities.

It was also asked whether there were specific funds available for dementia-related care. The Director of Community Services stated that whilst there was not a specific pooled budget for dementia, there were different funding streams from which the Authority could draw funding to undertake information dissemination or promotional activities. He reminded the Committee that the Local Authority was not permitted to use its funds to pay for health care as there were different legal requirements governing the activities of the NHS and local authorities in relation to charging for services. 

RESOLVED that the draft Plan be endorsed for consideration by the Executive Board.

Councillor K. Madge declared a personal interest in that his daughter works in Social Care Services.

The Committee considered the Revenue & Capital Budget Monitoring Reports relating to the Social Care & Health Service for the period up to 31st August 2015. The Committee noted that the Social Care & Health Service was projecting that it would be over its approved budget by £685,000 at the year end whilst the capital programme showed a net variance of -£228,000 against the 2015/16 approved budget.

The following issues were raised during consideration of the report:

In response to a question about the staff vacancies in the Enablement Service, the Director of Community Services noted that due to the nature of this service and the volume of staff, there was traditionally a high turnover in this area.

Reference was made to the timeliness of the report which was for the period up to the end of August 2015. The Director of Community Services and the Group Accountant reminded the Committee that this was a very complex budget but that as budget monitoring was undertaken on a bi-monthly basis. The most recent update (for the end of October) would not have been ready to meet the agenda deadline for the November meeting. However, for large or significant projects/services, more regular budget monitoring exercises were undertaken by the relevant officers.

RESOLVED to receive the report.

The Committee UNANIMOUSLY RESOLVED to suspend standing orders during consideration of this item so that the remaining agenda items could be considered.

Councillor K. Madge declared a personal interest in that his daughter works in Social Care Services.

The Director of Community Services suggested that in light of the time, the Committee consider deferring this item to its next scheduled meeting as this would afford members the time to discuss the report in more detail.

The Committee UNANIMOUSLY RESOLVED that the report be deferred for consideration at its next meeting on the 14th December 2015.

The Committee considered a referral from the Policy & Resources Scrutiny Committee. The Assistant Consultant explained the background for the referral and updated the Committee on the proposals for a new format for the performance monitoring reports received by scrutiny committees which would be shared with elected members at a briefing session on the 14th January 2016 (2:00pm).

RESOLVED that the report be received.

The Chair reminded the Committee of the Joint-Meeting with the Education & Children Scrutiny Committee on Monday 23rd November 2015 which had been arranged specifically for consideration of the Care & Social Services Inspectorate Wales’ (CSSIW) Inspection, Valuation and Review of Local Authority Social Services 2014/15 report. She requested that if possible, all members make an effort to attend.

RESOLVED that the explanation for the non-submission of the CSSIW’s Inspection, Valuation and Review of Local Authority Social Services 2014/15 report, be noted.

The Committee considered an update detailing progress in relation to actions, requests or referrals emerging from previous scrutiny meetings.

RESOLVED that the update be received. 

RESOLVED that the minutes of the meeting held on Wednesday 16th September 2015, be signed as a correct record.