Agenda and draft minutes

Health & Social Services Scrutiny Committee - Tuesday, 24th January, 2023 10.00 am

Venue: Chamber - County Hall, Carmarthen. SA31 1JP and remotely. View directions

Contact: Emma Bryer  01267 224029

Media

Items
No. Item

1.

APOLOGIES FOR ABSENCE

Additional documents:

Minutes:

An apology for absence was received from Councillor M. James.

 

On behalf of the Committee the Chair extended sympathy to  Councillor M. James on her recent family illness and bereavement.

 

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

A. Evans

5. Revenue & Capital Budget Monitoring Report 2022/23

6. Revenue Budget Strategy Consultation 2023/24 to 2025/26

Mother works in the Chief Executives Department – Democratic Services Unit.

 

There were no declarations of any prohibited party whips.

 

3.

PUBLIC QUESTIONS

Additional documents:

Minutes:

4.

YOUTH JUSTICE MANAGEMENT PLAN 2022/2023 pdf icon PDF 112 KB

Additional documents:

Minutes:

The Carmarthenshire Youth Justice Plan for 2022/23 was presented to the Committee.

 

Consideration was given to the governance, leadership and partnership arrangements which had culminated in the development of the Youth Justice Plan, set out at Appendix 1 to the report, in accordance with the legislative requirements of the Crime and Disorder Act 1998.

 

The Youth Justice Plan outlined the provision of the Youth Support Service and the Youth Justice Team under a single management structure which provided a holistic approach to the delivery of youth support services across Carmarthenshire.  Section 8 of the Youth Justice Plan detailed the performance of the partnership during 2021/22 and also set out the priorities and improvement planning objectives for the forthcoming year in accordance with the overarching ‘child first’ principles and an ethos of continuous improvement.

 

On behalf of the Committee, the Chair commended the crucial work and commitment of the partnership and staff working within the Youth Justice Team and asked if any work was being undertaken regarding gambling addiction. It was clarified that there was a dedicated substance misuse team that worked directly to provide support or if further support was required individuals may be referred to other agencies as part of the multi-agency working arrangements.

 

UNANIMOUSLY RESOLVED that the Carmarthenshire Youth Justice Plan for 2022/23 be received.

 

5.

REVENUE & CAPITAL BUDGET MONITORING REPORT 2022/23 pdf icon PDF 105 KB

Additional documents:

Minutes:

The Committee considered the Revenue and Capital Budget Monitoring Report in relation to the Health and Social Services, which provided an update on the latest budgetary position as at 31st October, 2022 in respect of the 2022/23 financial year.

 

The Health and Social Services was projecting an overspend of £5,358K on the revenue budget and net variance of -£199K against the 2022/23 approved capital budget.

 

The Committees attention was drawn to the significant budgetary pressure on  Children’s Services and Learning Disabilities. 

 

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

 

·         It was asked if it was necessary to provide Out of County Placements.  The Committee was advised that the preferred option would always be for the County to provide support and that work had been undertaken within the fostering team to expand the support options available to avoid using Out of County Placements. 

·         It was asked if the specialist support for the 2 young people with highly complex needs would be a long-term requirement as it was noted that there was currently a £579K overspend in this area.  It was advised that the needs of these individuals on the packages of care were extreme and significant and unfortunately could not be provided in County at the present time.  Additionally, there had been an increase in the number of placements and that due to previous years underspend in this area the budget wasn’t available.

·         Reference was made to the overspend on agency staff.  Officers advised that there was a recruitment and retention policy in place and that a significant amount of work had been done in reducing the number of agency social workers.  It was stated that the use of agency staff would be the exception and not the norm.

·         An update was requested on the initiatives in place for the recruitment and training of social workers.  Officers advised that it was a very competitive marketplace and that there were limited qualified social care workers.  In addition to the Care Academi launched by the Authority, overseas recruitment was also being used and two individuals from Nigeria had been appointed subject to the completion of pre-employment checks.

·         Officers were asked what the additional cost of agency staff were compared to full time staff.  The Committee was advised that the hourly rates varied significantly but that that a single point of contact was now in place within the Children and Adult Services team to undertake rate negotiations with agencies.

 

UNANIMOUSLY RESOLVED that the report be received.

 

6.

REVENUE BUDGET STRATEGY CONSULTATION 2023/24 to 2025/26 pdf icon PDF 90 KB

Additional documents:

Minutes:

The Committee considered the Council’s Revenue Budget Strategy 2023/24 to 2025/26 which provided a current view of the revenue budget for 2023/2024 together with indicative figures for the 2024/25 and 2025/26 financial years.  The report was based on officers’ projections of spending requirements and took account of the provisional settlement issued by Welsh Government (WG) on 14th December 2022.

 

It was emphasised that whilst significant work had already been undertaken in preparing the budget, the report represented an initial position statement which would be updated following the consultation process.  Accordingly, Members were reminded that the report had been considered by the Cabinet at its meeting on 9th January 2023 and members of the Committee had attended recent consultation events which had provided an opportunity to analyse and seek clarification on various aspects of the budget.

 

The Committee was advised that the final budget proposals would be presented to the Cabinet mid/late February, which would enable a balanced budget to be presented to County Council on the 1st March 2023.  It was however noted that due to the delays in the provisional settlement, and the consequential impact on Welsh Government’s budget finalisation, the publication of the final settlement would not be published until the 7th March 2023.

 

The report indicated that, after adjustments for WG, identified transfers, the increase in the provisional settlement for Carmarthenshire was 8.5% (£26.432 million).  The Aggregate External Finance (AEF) had therefore increased to £338.017 million in 2023/24.  Whilst the settlement represented a significant increase to the indicative figure of 3.4%, the financial model forecasted a requirement for £20m savings over the three-year Medium Term Financial Plan (MTFP) period.

 

It was highlighted that an additional £7.9m funding had been announced for Health, Social Services and Education and apportioned to Local Government resulting in an increase share of 8.5% for the Authority. 

 

It was noted that inflationary pressures were heavier than they had been in decades and that the inevitable cost rises would result in budgetary reductions.  WG also issued all Wales level specific grants alongside the provisional settlement.  These were broadly similar in cash value to previous years.  However, with the rise in inflation and the pay awards at the current level there were real term cuts. 

 

The Ministers letter stated that funding had been provided to cover the living wage increase and that all funding had been allocated.  The full cost of future pay awards would need to be accommodated locally.  In constructing the budget this had been challenging as the adjusted pay and inflation assumptions to provide departments with funding wasn’t sufficient. 

 

Members were reminded that when the budget was previously set, the agreed pay increase was 4% which was prudent at the time.  Pay increase for most staff was agreed at a flat rate of 2K (equating to an average of 7.1%) across the workforce.  An additional 3.1% ‘catchup’ would need to be factored into next year’s budget.  Reference was made to the 5% increase for all Teachers which had been agreed by  ...  view the full minutes text for item 6.

7.

2022/23 QUARTER 2 - PERFORMANCE REPORT (01/07/22-30/09/22) RELEVANT TO THIS SCRUTINY pdf icon PDF 161 KB

Additional documents:

Minutes:

The Committee considered the Performance Monitoring Report for the period 1st July to 30th September 2022 (Quarter 2), which set out the progress against actions and measures linked to the Corporate Strategy and the 13 Well-being objectives relevant to the Committee’s remit.

 

The Committee noted that only 3 of the 13 objectives were off target and appreciated that this was partly due to the pandemic resulting in a cohort of children not being seen and assessed early.  Assurance was given that the prevention team was now able to work closer with families and that the situation had improved.

 

UNANIMOUSLY RESOLVED that the report be received.

 

8.

DOMICILARY CARE STRATEGY UPDATE pdf icon PDF 102 KB

Additional documents:

Minutes:

The Committee considered a report they had requested surrounding the current pressure on domiciliary care and the impact that this was having on hospital discharges.  The report was to provide assurance that patients were being safely supported to leave hospital and outlined the pressures and how Carmarthenshire County Council was responding to those pressures.

 

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

 

·         In response to a question regarding how the Authority was increasing the flexibility of contracts and how this would impact the consistency of care provision, the Director of Community Services advised that there was an impact on the continuity of care and also on the ability to deliver at the best time for when people needed and wanted the care. The Committee was advised that the report set out what the Authority was doing to mitigate supply issues and assured the Committee that the Authority ensured that the care delivered did not impact on safety.   It was highlighted that there was an overall situation over the flexibility of care and that difficult conversations had to take place with families and individuals around what practical options of care were available.  In some cases, compromises would have to be made over the ideal package of care but this would still be preferable than remaining in hospital.  It was noted that there were currently around 50 individuals in temporary residential care, the majority of whom should be supported at home.  The situation was described as dynamic and that significant improvements had been made over the last few weeks, but the situation remained difficult.  It was highlighted that the Authority was attempting to offer more flexible contracts than the traditional rigid rotas to assist with the recruitment and retention of staff.

·         Concern was raised that the flexible contracts would result in lack of continuity of care with individuals ending up with a different number of carers.  It was advised that while several people may be providing care every effort was undertaken to ensure that this was kept to the same group of people.  It was acknowledged that this continuity was of benefit to both the individual receiving care and to the carer.

·         Clarification was sought regarding the use of microenterprises. The Committee was advised that the scheme was already in use in Pembrokeshire and that it was very early days for Carmarthenshire. The scheme was very much in its infancy and aimed to assist the areas where it was traditionally difficult to obtain domiciliary care.  It was stated that the Authority was in the process of recruiting a member of staff to lead on the initiative and drive it forward.

·         It was asked if the Authority had been pressurised into prioritising hospital discharges over those already waiting for care packages.  The Committee was advised that there was constant pressure balancing hospital discharges and community waiting lists and that there was some inevitability that those in the community would be waiting longer due to the prioritisation of hospital discharges.  Despite limited  ...  view the full minutes text for item 8.

9.

HEALTH & SOCIAL SERVICES SCRUTINY COMMITTEE FORWARD WORK PLAN FOR 2022/23 pdf icon PDF 132 KB

Additional documents:

Minutes:

The Committee considered its Forward Work Plan, which had been prepared and updated in accordance with the Council’s Constitution which required Scrutiny Committees to develop and publish annual forward work plans identifying issues and reports to be considered at meetings during the course of the municipal year.

 

It was noted that due to the Council decision in September 2022 that Scrutiny remits be amended the Committee re-visited its forward plan at a meeting held on the 9th January.  The Committee agreed the items for consideration at today’s meeting and the items for 9th March 2023:

 

The Committee noted the lack of Health and Social Services and Children’s’ Service reports on the Cabinet Forward Plan and agreed to meet again on 17th February to consider any relevant reports that had since been added.

 

The Committee agreed that an update on Loneliness (Task & Finish Report) as per its previous Forward Plan would still be required. This could be circulated outside of the meeting.

 

The Committee was advised that the Communities Department Business Plan 2021/22 – 23-24 that was originally due to be considered by the Committee on the 24th January would likely be delayed again pending re-development into separate Departmental Plans.  This would be confirmed at a later date.

 

UNANIMOUSLY RESOLVED that the Forward Work Plan for the Health & Social Services Scrutiny Committee for 2022/23 be confirmed and submitted to the March meeting for formal approval.

 

10.

EXPLANATION FOR NON SUBMISSION OF SCRUTINY REPORT. pdf icon PDF 70 KB

Additional documents:

Minutes:

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

 

·         Business Plan

·         Annual Report on the Wellbeing Objectives

 

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

 

11.

TO SIGN AS A CORRECT RECORD THE MINUTES OF THE MEETING HELD ON THE 5TH OCTOBER, 2022 pdf icon PDF 122 KB

Additional documents:

Minutes:

UNANAMOUSLY RESOLVED that the minutes of the meeting of the Committee held on the 5th October, 2022 be signed as a correct record.