Agenda and minutes

Apologies for absence were received from Councillors B. Davies, and J. Jenkins.

There were no declarations of personal interest or of any prohibited party whips.

The Chair advised that no public questions had been received.

The Committee considered a submission received from Mr Alex Williamson of the WAVE Trust requesting that the Committee explore whether:

• there were any gaps in the existing provisions that were in place within Carmarthenshire around the area of preconception and early years support.
• there were any gaps in the existing provisions that were in place within Carmarthenshire pertaining to front facing services such as housing, revenue and benefits and linked services such as Job Centre Plus regarding the implementation of trauma informed practices and/or trauma informed approaches.

Mr Alex Williamson presented his case and reasons to the Committee regarding why the issues raised should be reviewed.  Mr Williamson thanked the officers for the report and their transparency in acknowledging the areas for improvement.

Mr Williamson advised the Committee that since 2010 the WAVE Trust, had been campaigning to reduce the then reported level of children who had experienced abuse and neglect across the UK by at least 70% by 2030.  He stated that such a goal would only be achievable if the WAVE Trust were able to partner with local authorities across the UK and work with them to deliver local action plans.  Plans were already being developed across multiple councils in England and Scotland however, no local authority in Wales had yet made a commitment and asked the committee to consider wherever there was scope for Carmarthenshire to be the first.

The Chair advised Mr Williamsons that partnership working was outside of the brief of the Scrutiny Committee but possibly something that could be considered by the Commissioning Team. 

The Committee agreed that the report provided by officers provided a clear position on the current situation but noted that progress in addressing these gaps should be monitored by the Committee.  The Head of Children and Families suggested that the Committee should review the Family Support Strategy that was currently being developed. 

UNANAMOUSLY RESOLVED that the Family Support Strategy be added to the Forward Work Plan

The Committee considered the Revenue and Capital Budget Monitoring Report in relation to the Health & Social Services, which provided an update on the latest budgetary position as at 31^st August, 2023 in respect of the 2023/24 financial year.

The Health & Social Services was forecasting an overspend of £7,902k on the revenue budget. The main variances on capital schemes indicated a forecasted variance of -£14k against a net budget of £1,139k on social care projects, and a -£230k variance against the Children Services projects net budget of £517k.

Cabinet Member for Health & Social Services highlighted that the forecast budget overspend on Children’s Services was an area of significant concern to the corporate budget position and in recognising this a working group had been set up to investigate and identify corrective action where possible.  The Committee was advised that the working group met weekly and was chaired by the Deputy Chief Executive and included senior officers from across the Council as well as the Children Services leadership team.

Again, the Committee expressed their concern that the report only covered the budgetary position as at 31^st August.  The Group Accountant advised that it took approximately two months to create and review the reports, and for the report to progress through the democratic process but assured the Committee that the Accountancy Team periodically reviewed the process but had yet been able  to find a way of reducing the length of time it took to generate the reports.  It was also stated that the report was the forecast for the whole year and not just for August.

In response to a question regarding the financial increase for the provision of home care and adult services the Director of Community Services advised that due to inflation the situation was worse and that it would be difficult to factor this into the budget.  It was highlighted that keeping some posts vacant (such as Social Workers) would be counterproductive as commissioning costs would be higher.

UNANAMOUSLY RESOLVED that the report be received.

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.

This report was the third update the Committee had received which included the latest available data captured up to the end of September 2023.

The Cabinet Member for Health & Social Services highlighted improvements had been seen particularly since August 2023 and that this was aligned to the relaunch of the Domiciliary Care Framework and the addition of 4 new care providers that had built further capacity into the sector.   Consequently, there had been an overall growth in the number of hours commissioned for domiciliary care and a reduction in hours and people waiting across community and hospital sites.

It was noted that while progress had been made, there was still a significant amount of unmet need that necessitated monitoring to ensure that people remained safe whilst waiting for care.

The Cabinet Member for Health & Social Services advised that fortnightly meeting were being held to review long hospital waits to ensure that all options had been considered thus reducing the number of people with a long wait in hospital.  Also, twice weekly hospital escalation panels were being held where all difficult cases were escalated.  These reviews of long stay patients had significantly reduced those with a length of stay of over 100 days which in turn would have a positive impact on social care commissioning.

It was noted that the Authority also offered Delta CONNECT and direct payments to both the person needing the care and also to the carer who provided care to support individuals whilst they were caring for someone waiting for care.

It was advised that the growth in the number of hours commissioned for domiciliary care was approximately 7% for the first 6 months of 2023-2024. The projected overspend for the current year was approximately £1m – assuming further growth in October - March.  This was partially offset by the reduction in hours delivered by our inhouse service.  There was a projected underspend in the inhouse service of £727k (as at August 2023 budget monitoring) due to staff recruitment issues.

In response to a question regarding the re-launch of the Domiciliary Care framework and the fall-back position for the services provided by the commissioning, the Director of Community Services advised that having 4 Domiciliary Care agencies was advantageous as if one went bankrupt there were three other agencies available.  The importance of having an in-house service to provide continuity of care was highlighted and considered to be an essential element of care provision.

In response to reference made regarding the Health Board statistics concerning hospital discharge and those waiting for care, the Acting Head of Integrated Services advised that work was being done at the ‘hospital front door’ to identify the frailer people  ...  view the full minutes text for item 6.

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

·    Youth Justice Plan

·    Short breaks/community services for disabled children and their families

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

RESOLVED that the list of forthcoming items to be considered at the next scheduled meeting on the 18^th December, 2023 be noted.

UNANAMOUSLY RESOLVED that the minutes of the meeting of the Committee held on the 4th October, 2023 be signed as a correct record.