Agenda and minutes

Apologies for absence were received from Councillors R.E Evans and M. James.

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 Annual Report of the Statutory Director of Social Care Services 2022/23 which detailed the performance of social care services in the county.

There was a statutory requirement for the Director of Social Services to report annually to their Council on the delivery and performance as well as plans for the improvement of the whole range of Social Services.

It was noted that the report was still in draft and would be further revised prior to completion.

The Director of Community Services highlighted some of the key headline issues detailed within the report.  He advised that adult services area was recovering from the pandemic and had been under severe stress primarily due to lack of resources.  It was stated that the source of the recruitment difficulties was due to the overall state of the employment market as there aren’t enough working age people to do the jobs across all sectors including hospitality.  A major revision had been done on recruitment and retention but that it had not resolved all the fundamental shortages within the workforce. .

The Committee noted that in terms of older people the report identified the length of hospital stay with 75% and sometimes up to 80% of frail and elderly people within those bed with the average length of stay in Glangwili and Prince Philip hospitals being more than double that of equivalent hospitals.

In terms of learning disabilities, the Authority had met new demand and the number of people entering formal residential care had not increased however, it was felt that progress in mobilising community resource to support and reduce the overall number of people in residential care was not progressing as anticipated due to the length of time required to set up alternative settings.

The Director of Community Services informed the Committee that in relation to children with disabilities the service was seeing an increase in demand from families and the number of children on the child protection register had also increased.  Despite the issues evidence showed that the Authority was making safe judgements in relation to children.

The Chair noted the positive comments from CIW and thanked the Director of Community Services and staff involved for their hard work.

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

·    In response to concern raised about the record deficit with the Health Board budgets and the potential impact this may have on the  Authority, the Director of Community Services advised that between Welsh Government and the Health Boards some difficult decisions would have to be made.  However, it was prudent to identify that any joint initiatives such as Delta Well-being could be impacted but that strategically the Authority had a very good relationship with the Health Board and it was hoped that initiative which were saving money and meeting need would not be impacted. 

·    In relation to the risk identified regarding the high rate of inflation, the Director of Community Services responded by advising that the Authority was having to absorb  ...  view the full minutes text for item 4.

The Committee considered the Revenue Budget Outturn Report for 2022/23 which provided an end of year financial position. It was noted that the Health and Social Service showed a net variance of -£6,254K against the 2022/23 approved budget.

The report included information relating to the following:-

·         Summary position for the services with the Social Care and Health Scrutiny Committee remit;

·         Report on Main Variances on agreed budgets;

·         Detailed variances;

·         Details of the Savings Monitoring position for the end of the year.

The Cabinet Member for Resources indicated that many of the budget lines had significant variances to the budget that was set during February 2022 and that this reflected the uncertainty of demand, cost and capacity in the service areas.  It was stated that the demographic pressures in learning and disability services were continuing to have an impact on the budget for residential placements and supported accommodation. 

The Committee noted that the pressures emerging in Children’s Services in the last financial year were as a result of staffing pressures and the complexity of care provision and that this was a significant concern to the corporate budgetary position.

A number of questions were raised, the main matters were as follows:

• It was asked if the additional budget allocated in 2022/23 to address the issue around the recruitment of social workers had been spent wisely as there had been a wide range of initiatives launched.

The Head of Children and Families re-iterated that the challenge facing the Authority around the recruitment of qualified social workers couldn’t be overestimated and that it was a national challenge.  She stated that there were many Local Authorities in Wales operating with a high percentage of agency social workers within their workforce but that Carmarthenshire had in large been able to stop.  It was stated that there was a joined-up consistent approach across the divisions regarding social work recruitment.  Many initiatives had been undertaken to address feedback received via a social worker survey with one being the practitioner progression framework.  It was stated that Social Care Wales had recently advised that the number of people applying for social work courses had increased and that this was due to the increase in the bursary that was made available. 

The Head of Adult Social Care reminded the Committee of the Care Academi initiative.  12 people were currently on the programme and had placements in residential and day services facilities while undertaking their NVQs and then would be supported ultimately to attain their Social Work degree.

• In response to a question regarding what the impact would be on the headline budget should every post be filled, the Director of Community Services advised that there was unmet demand and that if posts in areas such as home care were filled it was estimated that a further 2m would be spent.  Alternative models of care had been implemented to reduce cost and the number of staff required.  It was stated that one of the challenges was in relation to posts in areas  ...  view the full minutes text for item 5.

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 30^th June, 2023 in respect of the 2023/24 financial year.

The Health & Social Services was forecasting an overspend of £7,325k on the revenue budget. The main variances on capital schemes indicated a forecasted variance of £44k against a net budget of £1,157k on social care projects, and a £1k variance against the Children Services projects net budget of £517k.

The Cabinet Member for Resources 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.

In response to a query the Director of Community Services confirmed that the variances in the first quarter were about where they were expected to be based on historical assumptions.  In relation to the issue raised regarding the deficit with Children’s Services it was highlighted that this was not a new issue and that it had previously been masked by one off grants from Welsh Government.  The Director of Community Services stated that he hoped that the overall diagnostic of the root causes of the deficit would enable the Authority to take corrective actions but that an action plan will be produced by the end of October / early November.  It was stated that there had been a huge increase in cost of services and the commissioned profile of services in relation to residential care services for children with disabilities.  Additionally, the Authority was faced with an increase in demand for services and that investigations were being undertaken to establish the root cause of this demand post pandemic.

The Committee once again asked regarding the out of county placements.  In response the Director of Community Services expressed concern that the provision of care did not meet the needs of children and was commercialised and often provided poor service at high cost.  The Committee was advised that ideally the Authority would develop their own resources with sufficient capacity in the Couty to meet the demand and that only in exceptional circumstances were children placed out of county.

UNANAMOUSLY RESOLVED that the report be received.

UNANAMOUSLY RESOLVED that the list of forthcoming items to be considered at the next scheduled meeting on the 28^th November, 2023 be noted.

UNANAMOUSLY RESOLVED that the minutes of the meeting of the Committee held on the 5^th July, 2023 be signed as a correct record.