Agenda and draft minutes

Apologies for absence were received from Councillors A. Evans, H. Jones and D. Owen

Apologies were also received from Councillor A. Lenny, Cabinet Member for Resources and from Councillor J. Tremlett, Cabinet member for Health and Social Services.

There were no declarations of prohibited party whips.

The Chair advised that no public questions had been received.

The Committee considered the Revenue and Capital Budget Monitoring Report in relation to Health & Social Services within the Committees remit, which provided an update on the latest budgetary position as at 31^st August, 2024 in respect of the 2024/25 financial year.

It was noted that Health & Social Services was forecasting an overspend of £7,025k on its revenue budget. The main variances on capital schemes indicated a forecasted variance of £0k against a net budget of £728k on social care projects, and a -£14k variance against the Children Services projects net budget of £136k.

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

·       In response to a question relating to the funding of unaccompanied children asylum seekers, some of whom may have special needs, it was confirmed the Home Office provided local authorities with funding to fulfil their legislative requirements to provide for the children housed within their area.

·       Reference was made to the numbers of unaccompanied children asylum seekers located within Carmarthenshire. It was noted the relevant information had been provided at a previous meeting of the Committee.

·       In response to a question on whether Home Office funding for unaccompanied child asylum seekers covered all costs associated with their placement, the Committee was informed that as that information was not readily available at the meeting it would be forwarded to members of the Committee direct.

·       Reference was made to the projected £7m revenue overspend at the end of August 2024 for services falling within the Committees remit and clarification sought on whether that could increase further. It was reported that as preparation of the budget monitoring report to the end of October 2024 was currently being prepared, it was too early at the present time to predict whether the overspend would increase or decrease. However, in so far as the Social Servies overspend was concerned, it was anticipated the current £2m overspend would not vary significantly. It was also noted that the projected £4m overspend relating to Children and Families lay within the Education and Children Directorate. An updated budget report would be submitted to the next meeting.

·       Reference was made to the budget for Commissioning and Social Work within Children and Families, recording £500k income and the note attached thereto stating increased costs were partly offset by additional grant income and part year staff vacancies. Clarification was sought on whether that position could be sustained and if the grants would still be available for the next financial year. It was reported that the budget would have been prepared on the basis the grant funding would be available to the end of the current financial year.

·       Reference was made to the legal costs associated with the Commissioning and Social Work within Children and Families and to whether that involved external or internal solicitors. It was confirmed the costs were attributable to the complexity of cases and capacity within the legal division and those costs were regularly monitored. However, the matter would be  ...  view the full minutes text for item 4.

(NOTE:

1.     Councillor S. Williams having earlier declared an interest in this item remained in the meeting for its consideration

2.     Councillor K. following a reference made to community pharmacies during committees consideration of this item declared an intererst in that she was Community Pharmacist and remained in the meeting for its consideration).

The Committee considered a report it had requested surrounding the current pressure on domiciliary care and the impact that was having on hospital discharges together with providing an assurance patients were being safely supported to leave hospital, outlining sevice pressures and how Carmarthenshire County Council was responding to those pressures.

This report was the fifth update the Committee had received which included the latest available data captured for Quarters 1 and 2 for 2024/25.

The following questions / issues were raised on the report.

·       Reference was made to the increase in the number of commissioned hours for domiciliary care. While it was acknowledged efforts were being made to increase the number of internal care staff, clarification was sought on whether the increased hours resulted in increased agency costs.

The Acting Head of Integrated Services confirmed that while the issue of agency costs was a concern, the department was aggressively recruiting for additional internal staff to achieve the targetted 50% provision. However, it was acknowledged agency staff would be required to cover for periods of staff sickness and leave etc but that the associated costs were continually monitored.

·       Reference was made to the current concerns within community pharmacies on the level of funding received from the Welsh Government and their ability to continue to provide community services. Clarification was sought on whether the authority was aware of those issues.

The Acting Head of Integrated Services advised that she was not aware of the concerns referred to and requested that the member forward those to her to assess whether they may have an impact of the provision of the council’s services.

·       The committee welcomed the reference in the report that no patients were being discharged from hospital without the appropriate care packages being in place

·       In response to a question, the Acting Head of Integrated Services confirmed the delays encountered in undertaking assessments to facilitate the discharge of patients from hospital were reducing month on month.

·       Reference was made to the position that not all the reasons for a delay in assessments related to Social Services assessments with some being attributed to the Health Board. The Acting Head of Integrated services in response confirmed that the delays in Pathway Care were high on the Welsh Governments Agenda, and that included hospital delays. However, it should be noted that as the Council progressed with its Prevention Strategy, the medical condition of patients left in the hospital environment were becoming increasingly complex.

UNANIMOUSLY RESOLVED that the report be received.

The Committee considered a report it had requested on the current position of the development of the Prevention Strategy for Carmarthenshire.

It was noted that there was currently no prevention strategy in place for Carmarthenshire or for the Hywel Dda Region and the closest report of a similar nature was the ‘Prevention, Early Intervention, Promoting Independent Living Carmarthenshire: A Resilient Community’ developed in 2016.  Therefore, it was acknowledged that an updated prevention strategy which took into account the current position and set out the prevention vision for the future was required.

The Committee was advised that regional & local governance arrangements had been progressed with the establishment of a Regional Preventions Board.

Officers advised that there was a programme of work developing the preventative/community-based initiatives with third sector organisations and CAVS.  This also included the development of social and micro enterprises.

It was noted that the Carmarthenshire Prevention Strategy was currently being developed with partners and was in the advanced stages of development and, once ready, would be shared with the Carmarthenshire Prevention Group for review and approval and with the Regional Prevention Group for information. The fully completed strategy would then be taken to the Healthier Carmarthenshire Group for approval and the Health Board Executive Lead would also seek its approval through the Hywel Dda UHB Executive Board. It was anticipated the final document would be submitted to the Council’s Cabinet for approval in April 2025

UNANIMOUSLY RESOLVED that the update report be received.

(NOTE: Councillor S. Williams having earlier declared an interest in this item re-declared that interest and remained in the meeting for its consideration)

The Committee considered an interim report on the implementation of the Dementia Strategy together with a Position Statement on Dementia Care in Carmarthenshire.

The Strategy detailed a West Wales vision for dementia services, to ‘Support each person to live well and independently with dementia for as long as possible’ and outlined a dementia wellbeing pathway focussing on streamlining pathways and placing people living with dementia and their carers at the centre of service provision. It was noted the interim report aimed to outline the context of the work of the Regional Dementia Steering Group in implementing this strategy across Carmarthenshire, Pembrokeshire and Ceredigion and that further feedback regarding the impact of this work within Carmarthenshire would be presented to a future Scrutiny meeting following internal ratification of their update report. 

The following questions / issues were raised on the report:

·       In response to a question on the next steps for 2022/23 (as detailed on page 51 of the report), it was confirmed the report was interim with not all the data currently being available. The report was currently with the Welsh Government and following its return an updated report would be presented to a future meeting of the Committee. Additionally, the report provided an overview of current provision which was being examined with a view to identifying whether there were any gaps and how those could be addressed in terms of catering for future demand over the next 15 years

·       Reference was made to the numerous partner agencies/ departments associated/ involved with the strategy and clarification sought on what measures were in place to address any shortfalls/failures in service provision by one of those agencies.

The Senior Delivery Manager advised that would be addressed by a mapping and gapping exercise with co-ordination between the various partners being key issue to bringing them all together thereby ensuring they could work as one on the future provision of dementia care within Carmarthenshire.

·       In response to a question on funding sustainability in care provision, the Senior Delivery Manager advised that would be addressed via the mapping and gapping process to ensure service provision was robust and adequately staffed, which involved liaising with finance managers for funding future provision.

·       In response to a question on the provision of grant support by outside bodies, the Acting Head of Integrated Services advised its provision was a concern and that the service needed to be smarter on funding core sustainability services and that the issue was currently being examined as part of the budget process. For example, with 45% of people living with dementia being over the age of 85, with that age group expected to grow substantially over the next 20 years, funding would need to be addressed as part of future social service provision.

UNANIMOUSLY RESOLVED that the proposed strategic focus for the future of the work on Dementia in Carmarthenshire be  ...  view the full minutes text for item 7.

The Committee considered a report on the development of the ‘early Help Strategy’ for Children and Young People detailing how we ensured families received accessible, co-ordinated Early Help when needed across a continuum, from universal preventative approaches through to more targeted help where families are experiencing more complex and multiple difficulties aimed at preventing statutory intervention.

The Strategy’s main principles were:

• Right Help - Key to achieving our aims for supporting children and young people in Carmarthenshire is a commitment to early help through a range of evidence-based interventions.

• Right Time - Early Help may be needed at any point in a child or young person’s life, and we will offer support quickly, to reduce the impact of problems that may have already emerged.

• Right way for Families - Families are best supported by those who already work with them organising additional support with local partners as needed.

If adopted, it was anticipated the strategy would be adopted by the Council’s partners in December 2024.

The Committee also noted the report detailed a number of next steps to further progress the strategy which included further development of the Council’s Early Help Hubs and working with partner organisations.

The following questions/ issues were raised:

·       In response to a question on community engagement with the strategy, the Head of Children and Families advised that initially engagement would only be with the Council's statutory partners. As that progressed there may be an opportunity to engage with the wider community as a means of disseminating information on the services available and how those could be accessed.

UNANIMOUSLY RESOLVED that the Early Help Strategy be received.

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

·       Youth Justice Plan

·       Update on Loneliness Task and Finish Actions

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

RESOLVED that the list of forthcoming items to be considered at the next scheduled meeting on the 3^rd February, 2025 be noted.

UNANAMOUSLY RESOLVED that the minutes of the meeting of the Committee held on the 21^st October, 2024 be signed as a correct record.

THE REPORTS RELATING TO THE FOLLOWING ITEMS ARE NOT FOR PUBLICATION AS THEY CONTAIN EXEMPT INFORMATION AS DEFINED IN PARAGRAPH 14 OF PART 4 OF SCHEDULE 12A TO THE LOCAL GOVERNMENT ACT 1972 AS AMENDED BY THE LOCAL GOVERNMENT (ACCESS TO INFORMATION) (VARIATION) (WALES) ORDER 2007. IF, FOLLOWING THE APPLICATION OF THE PUBLIC INTEREST TEST, THE CABINET  RESOLVES PURSUANT TO THE ACT TO CONSIDER THESE ITEMS IN PRIVATE, THE PUBLIC WILL BE EXCLUDED FROM THE MEETING DURING SUCH CONSIDERATION.

UNANIMOUSLY RESOLVED, pursuant to the Local Government Act 1972, as amended by the Local Government (Access to Information) (Variation) (Wales) Order 2007, that the public be excluded from the meeting during consideration of the following items as the reports contained exempt information as defined in paragraph 14 of Part 4 of Schedule 12A to the Act.

Following the application of the public interest test it was UNANIMOUSLY RESOLVED, pursuant to the Act referred to in Minute Item 12 above, to consider this matter in private, with the public excluded from the meeting as disclosing the information contained in the report could unfairly undermine the company’s position in relation to its competitors when operating in a highly competitive commercial market.

The Committee received the Llesiant Delta Wellbeing Annual Report for 2023/24.

UNANIMOUSLY RESOLVED that the report be received.