Agenda and draft minutes

Apologies for absence were received from Councillors M. Donoghue, H. Jones and B.A.L. Roberts.

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 the Direct Payment Service Report which they had requested.  The report provided an up-date on the Direct Payments service in Carmarthenshire.  It set out the progress that had been made since the management and support function was transferred to Carmarthenshire County Council.

A number of questions were raised to which officers responded. The main matters were as follows:

·    In response to a query regarding why the Sum of Active Week’s cost per population group was low for Mental Health, officers advised that typically the number of direct payments for Carmarthenshire individuals with Mental Health was reflected across Wales. It was stated that Mental Health support could be more fluctuating with the peaks and troughs of the care needs of the individuals but that direct payments was still an active offer for all.  It was highlighted that some of those included within the figures for Learning Disabilities often had dual diagnosis so they may have a Mental Health issue and also Learning Disabilities.

·    In reference to the high figures for Learning Disabilities, it was asked if this was higher due to less activities happening in the communities.  The Commissioning and Contracting Manager advised that through Direct Payments, people were having the opportunity to do the things that they’re interested in while supported by a PA.  It was noted that there had been a shift towards personalisation of care and support planning and people were exercising their choice and control and community support was the largest area of activity.  It was stated that the number of recipients receiving community support was high and that it was very much about people having the opportunity to do the things that mattered to them.  Additionally, the Commissioning and Contracting Manager advised that the Authority was looking at opportunities where pooled Direct Payments could benefit groups of people who have shared interests.  The Head of Adult Social Care advised that part of the plan was to look at a more cost-effective service and as an example stated that you may have five individuals going to the same event taken by five Personal Assistants and that by pooling payments this would save resources.

·    It was asked how the Authority knew that the payments were being spent appropriately. In response, the Senior Business Support Manager advised that one of the big drivers for bringing the service back in-house was to ensure more rigorous checks and the application of financial regulations. It was advised that improvements had been made however there were still some areas of concern that needed to be addressed by working closely with the Social Workers and the Direct Payments Advisors who were dealing with the families on a day-to-day basis.

·    It was asked if there was a waiting list of people waiting to be assessed.  Officers advised that there wasn’t a waiting list however there were challenges around the recruitment of PA’s however work was continuing to both communicate and increase the exposure of the role and to improve retention.

UNANIMOUSLY RESOLVED  ...  view the full minutes text for item 4.

The Committee considered the 2023/24 Quarter 4 - Performance Report Relevant to this Scrutiny’s Cabinet Vision Action and Measures. The report showed the progress as at the end of Quarter 4 – 2023/24 of the deliverables for the Cabinet Vision.

A number of questions were raised to which officers responded. The main matters were as follows:

·    In response to a query regarding the Task & Finish Group that had been established to focus on the development of a rehab model for the Community hospitals, the Acting Head of Integrated Services advised that the Task & Finish included the Council and the Health Board and involved a number of clinical and medical professionals, therapy leads, social workers and nurses.  It was stated that the group was looking at ways of improving the bed-based offer and to maximise outcomes for people. Currently the specific area of work was in relation to Amman Valley Community Hospital and was looking to mirror the roll out of the model implemented at Ty Pili Pala which is the bed based intermediate care centre located in Llys Y Bryn care home.  The work had already resulted in the reduction of hospital stay by a third.

·    In response to a query regarding the Section 33 agreement, the Acting Head of Integrated Services advised that the overarching legal document had been completed but the supporting schedules which were critical to the agreement had yet to be finalised.  These schedules contained the detail of what each service delivers and underpins the overarching legal document.  Work on the urgent care and flow schedule was almost complete but there was still work to be done on  prevention and proactive care pathway and the long-term pathway schedules.

·    In reference to the issue regarding the increase in the rates of suicide and self-harm in the County the Head of Adult Social Care advised that a significant amount of work was being undertaken including the establishment of a suicide review group.  The group would be looking to see if there were any themes and geographical and demographical areas of risk that would drive the prevention strategy.  In addition, it was stated that work was continuing on ensuring people were made aware of where to turn to for support.  The Committee was assured that the mission was to reduce the number of suicides in the region and that this was being undertaken collaboratively with partner organisation.

·    In response to a query regarding the appointment of a temporary co-ordinator role the Head of Adult Social Care advised that the post had been created as it was recognised that there were a number of initiatives and third sector groups providing support around suicide prevention but that there was limited cohesion or understanding on where to go or how to access these services.  Funding had been provided by one of the GP clusters to appoint a person for an initial three months but they had now been in post for around nine months.  Significant work had been done with ‘mapping and  ...  view the full minutes text for item 5.

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

·         Update on Early Help Strategy

·         Dementia Strategy

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 17^th October, 2024 be noted.

UNANAMOUSLY RESOLVED that the minutes of the meeting of the Committee held on the 13^th June, 2024 be signed as a correct record.