Agenda and draft minutes

Social Care & Health Scrutiny Committee - Tuesday, 5th October, 2021 10.00 am

Venue: Virtual Meeting. View directions

Contact: Emma Bryer  01267 224029

Media

Items
No. Item

1.

APOLOGIES FOR ABSENCE

Additional documents:

Minutes:

Apologies for absence were received from Councillors R. E. Evans and B.A.L. Roberts.

 

On behalf of the Committee the Chair extended condolences to Cllr. Roberts and family on the sad passing of her husband.

2.

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

Additional documents:

Minutes:

Councillor

Minute No (s)

Nature of Interest

Ken Lloyd

4. Revenue & Capital Budget Monitoring Report 2021/22

5. 2021/22 Quarter 1 Performance Report (1st April to 30th June 2021)

6. Impact of Covid-19 on Carmarthenshire's Adult

Social Care Services

7. Domiciliary Care, Social Work Workforce And

Market Pressures

Family member is a carer in the Shared Lives Scheme.

Kevin Madge

4. Revenue & Capital Budget Monitoring Report 2021/22

5. 2021/22 Quarter 1 Performance Report (1st April to 30th June 2021)

6. Impact of Covid-19 on Carmarthenshire's Adult

Social Care Services

7. Domiciliary Care, Social Work Workforce And

Market Pressures

Daughter works in Social Care.

 

There were no declarations of any prohibited party whips.

3.

PUBLIC QUESTIONS (NONE RECEIVED)

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Minutes:

The Chair advised that no public questions had been received.

4.

REVENUE & CAPITAL BUDGET MONITORING REPORT 2021/22 pdf icon PDF 240 KB

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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 30th June 2021, in respect of 2021/22 financial year.

 

The Cabinet Member for Resources advised that the Social Care & Health Service was projecting an overspend of £492K on the revenue budget and a net variance of £97K against the 2021/22 approved capital budget.

 

The following questions / observations were raised on the report:

 

Appendix A

·         Concern was raised regarding the significant predicted overspend when large parts of the service had not been delivered due to Covid. It was also asked if any additional funding would be provided by Welsh Government what had not been included in the figures.

The Group Accountant advised that grant offers had been received within the last few weeks and also some Social Care recovery funding. Work was on-going on how best to spend the funding but it would be invested in providing services and interventions.

Appendix B

·         In relation to Learning Disability – Private Day Service it was asked what the ‘alternative’ service was that had been provided.

The Committee was advised that it was a combination of some services being brought back in-house and 1-2-1 support provided at home when appropriate.

·         Concern was raised regarding delays to the re-opening of the day centres.

The Head of Integrated services advised that discussions regarding the plans for re-opening the service were well underway and that the Authority was very clear that the service would be re-opened. Three key areas had been undergoing assessment - building risk assessments, transport and staffing to ensure alignment with Government guidelines. Initially the re-opening would be a scaled down service to ensure safety of both staff and service users. 

·         An update was requested on Cwm Aur and the partial delivery of savings.  It was stated that costs had not increased and that at the time of setting the contract potential savings had been identified but not delivered. The committee was advised that a fuller description would be included within the next report.

·         It was asked why direct payments for mental health and physical disability had increased when direct payments for older people had reduced.

The Head of Integrated Services advised that managing direct payments brought with it some challenges. Generally, older people had less capacity and / or capability to manage direct payment and that having the council commissioning on their behalf removed the stress. On the whole, younger people wanted to manage their own services and were often supported by family.

Appendix E

·         Further clarity was requested regarding the Capital budget which was stated as Awaiting 2022/23 awards and which financial year would the awards be received.

The Committee was advised that a response would be provided following the meeting.

Appendix F

·         It was asked how confident officers were that savings proposals would be achieved.

The Group Accountant advised that it was a reasonable assumption that the savings would be  ...  view the full minutes text for item 4.

5.

2021/22 QUARTER 1 PERFORMANCE REPORT (1ST APRIL TO 30TH JUNE 2021) pdf icon PDF 591 KB

Additional documents:

Minutes:

The Committee received the 2021/22 Quarter 1 Performance Report for the period 1st April to 30th June 2021 presented by the Cabinet Member for Social Care and Health in respect of the area falling within her portfolio and the Committees remit.

 

The report detailed the progress made against the actions and measures within the Corporate Strategy and on the delivery of the 13 Well-Being Objectives. The Committee noted that 2021/22 was the first year the Council would self-evaluate and report on under the terms of the Local Government and Elections (Wales) Act 2021, especially Part 6 relating to Performance and Governance.

 

 The following issues were raised on the report:-

 

·         Officers were asked to provide further information regarding ‘Rita’ in care homes.  It was stated that Rita was assistive technology being used with patients suffering cognitive problems such as dementia. The Committee was advised that Rita could help calm distressed or anxious patient by for example playing music and viewing photos.

·         Clarification was asked regarding Dementia Navigators. Officers advised that Dementia Navigators were employed by the Health Board within the Older People team and provided lower-level support for dementia sufferers.

·         Clarification was sought on how Care Homes voids were being let as efficiently as possible. Officers advised that voids were being used for emergency respite and temporary placements for people waiting for packages of care.  The Committee was advised that the number of voids had reduced and that the Authority was looking to increase the number of placements.

·         An update was requested regarding the investment programme for Care Homes.

The Head of Homes and Safer Communities advised that the Authority was undertaking a significant investment in care homes. It was acknowledged that the service provided was exceptional, but the physical environment needed improvements.

·         It was asked when the Welsh Government Strategy for an ageing society: age friendly Wales would be completed.

The Committee was advised that a grant had been awarded and to be used by the end of the financial year to support the development of plans to be an age friendly county.  An external company had been engaged to prepare the plan and that funding would also be used for engagement events.

 

UNANIMOUSLY RESOLVED that the report be received.

6.

IMPACT OF COVID-19 ON CARMARTHENSHIRE'S ADULT SOCIAL CARE SERVICES pdf icon PDF 398 KB

Additional documents:

Minutes:

The Committee received a report providing a position statement regarding how adult social care services were being sustained and highlighting the demand and pressures that were emerging as a result of the pandemic.

 

The report described how the Authority’s response was now business as usual, and how the Authority was responding to the emerging demand and pressures particularly in relation to assessment and domiciliary care demand.

 

The Cabinet Member for Social Care and Health advised that as Covid Recovery was now business as usual bespoke Covid updates would no longer be provided.

 

A number of questions / observations were raised on the report. The main matters were as follows:

 

·         It was asked if discussions had been had with the Health Board and Welsh Government regarding potential changes to the national guidance of 20-day closure for new admissions/visitors.

The Head of Integrated Services confirmed that discussions had been on-going.

·         It was asked what needed to be done now to prevent the recuring frustration regarding recruitment and retention of staff.

The Committee was advised that a long-term sustainable source of funding would be required.  Discussions were being held at a national level.  With existing level of funding received from Welsh Government the Authority couldn’t increase the rate of pay as an additional £5-6M of funding would be required.  All avenues were being explored including career structures, progression and trainee routes.

·         Officers were asked if the Authority offered an apprenticeship programme and if school pupils were being targeted.

The Head of Integrated Services advised that the Authority had links with colleges and universities and that the school’s option could be explored further.  The Cabinet Member for Social Care and Health advised that discussions had been on-going regarding potential taster sessions with six form pupils.

·         It was asked if the Authority would be recruiting someone to engage with the schools.

The Performance, Analysis & Systems Manager advised the Committee that a huge recruitment marketing campaign had been undertaken and that funding would be used to recruit a project officer.  Part of the project officer role would be to go into schools and colleges to drive recruitment and retention. 

·         Further clarification was requested regarding the in-house service sickness level of 16% and a detailed breakdown of what the nature of the sickness absence was.

·         Officers confirmed that there had been a high level of covid and covid contact absences and that Carmarthenshire had a high level of covid community transmission.  A breakdown of the sickness type would be provided to the Committee at a later date.

 

UNANIMOUSLY RESOLVED that the report be received.

7.

DOMICILIARY CARE, SOCIAL WORK WORKFORCE AND MARKET PRESSURES pdf icon PDF 225 KB

Additional documents:

Minutes:

The Committee received a report providing an overview of the growing workforce challenges within the domiciliary care market for both in house and commissioned sectors.

 

The report detailed current market pressures within the domiciliary care sector and the impact on both Health and Social Care within Carmarthenshire.  It also detailed Social Worker workforce pressures which was impacting on the ability to meet service user demand and having a significant impact on the performance of the department’s ability to meet the needs of vulnerable people in a timely way.

 

The report detailed actions to mitigate risks to ensure that statutory requirements under the Social Services and Wellbeing Act (Wales) 2014 were met.  Also detailed within the report were a number of recommendations for immediate action.

 

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

 

·         Officers were asked to expand on the impact that officer hoped the development of micro markets would have on rural areas.

The Head of Strategic Joint Commissioning advised that work had started on tapping into very hyper local solutions. The work was being led by Pembrokeshire County Council in conjunction with various partners such as Community Catalysts, Pembrokeshire CVC and Planed. The Committee were advised that Covid has acted as a catalyst for small enterprise set up.  There had been a lot of community interaction providing low level of day-to-day support which was not just restricted to health and social care.

·         Concern was expressed that if the Health Board stopped recruitment it would result in extra pressure on Council services. It was asked if discussions were taking place regarding bridging plans for community care.

The Head of Integrated Services advises that the Health Board and Authority were working closely and that an agreement was in place not to destabilise the rest of the workforce.

·         Concern was expressed that 5 domiciliary care framework providers had experienced workforce challenges and that one provider had handed back 10 packages of care.

The Head of Strategic Joint Commissioning reassured the Committee that the Authority had a duty of care and had sourced alternative suppliers

 

UNANIMOUSLY RESOLVED that the report be received.

8.

EXPLANATION FOR NON-SUBMISSION OF SCRUTINY REPORT pdf icon PDF 104 KB

Additional documents:

Minutes:

The Committee received an explanation for the non-submission of the following scrutiny reports.

 

·         Adult Social Services Complaints and Compliments Report Q1(Oct) & Q3 (March)

·         Communities Department Business Plan 2021/22 – 23-24

·         2020/21 End of Year Budget Monitoring – Outturn Report

·         Safeguarding Annual Report

 

RESOLVED that the explanation for the non-submission be noted.

9.

FORTHCOMING ITEMS pdf icon PDF 108 KB

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Minutes:

The Committee received a list of forthcoming items to be considered at its next meeting to be held on the 29th November 2021.

 

It was noted that as Covid Recovery was now business as usual separate covid update reports would no longer be provided.

 

RESOLVED that the list of forthcoming items to be considered at the next scheduled meeting on the 29th November, 2021 be noted.

10.

TO SIGN AS A CORRECT RECORD THE MINUTES OF THE MEETING HELD ON THE 7TH JULY, 2021 pdf icon PDF 324 KB

Additional documents:

Minutes:

UNANAMOUSLY RESOLVED that the minutes of the meeting of the Committee held on the 7th July, 2021 be signed as a correct record.