Agenda item

[NOTE: Cllr. K. Lloyd had earlier declared an interest in this item].

The Committee considered the Communities Departmental Draft Business Plan 2020 – 2023 in relation to those services falling within its remit:

·         Care and Support Services

·         Mental Health, Learning and Disability & Safeguarding

·         Integrated Services

·         Commissioning Services.

It was noted that further work would be undertaken on the draft business plan following comments and engagement by the Committee and Executive Board Members.  Additionally, feedback from staff groups to date had indicated greater emphasis would be welcomed on integrated wellbeing actions through divisional plans together with ensuring the sustainability of services through different methods in the face of growing demand.

The following issues/questions were raised on the report: -

·         It was asked what work was being done on developing the prevention agenda.

The Interim Head of Integrated Services advised that there was a focus on prevention and promotion of independence and that the Authority was engaged in a significant amount of work in this area. Examples provided included: the use of technology, Community Responders, working with GP practices, CUSP project, development of StayWell plans in conjunction with service users, re-engagement with the community and the Couch to 5k initiative.

·         The Committee asked for further information regarding the CUSP project.

The Interim Head of Integrated Services advised that the CSUP project was started about 18 months ago in collaboration with the third sector.  The CUSP service aimed to support people over the age of 18 years to maintain independence or become independent. Advice and support was provided on whatever was significant to the individual and could include areas such as financial management and gardening.  The CUSP service is provided free of charge however some users may choose to purchase the services of private companies following referrals. The Head of Mental Health and Learning Disabilities advised that there was focus on the preventative agenda and advised that when someone finds themselves in a difficult position, they need to speak to someone as early as possible to prevent escalation.  The crisis centre (Twilight Sanctuary) had been opened in Llanelli to help these people.

·         It was asked how the public were being made aware of the service provided by the Twilight Sanctuary.

The Head of Mental Health and Learning Disabilities advised that there had been a lot publicity and that the service would be advertised wider when the service was fully established.  The Committee was also advised that there was a possibility that a centre would be opened in Carmarthen.

·         An update was asked regarding how joint working with partners such as the Health Board and the third sector was progressing.

The Head of Mental Health and Learning Disabilities advised that historically there had been concerns however, partnerships were now working well.  Committee was advised that Carmarthenshire was very involved with the transformation programme and was working closely with the Health Board.  While work was continuing, it was not at the pace hoped for however projects were aligned with the transformation vision of a single point of access for Mental Health.  Joint funding was challenging but all parties had worked together to resolve.  It was stated that significant progress had been made despite the challenges.

·         An update was requested regarding the availability of acute beds as current shortage across Wales resulted in increased pressure on patients, carers and staff. 

The Head of Mental Health and Learning Disabilities advised that acute beds were not always the right place for individuals, however it was acknowledged that there was a need for these beds. This issue was constantly raised with the Health Board and the Twilight Sanctuary was investigating alternative solutions to the problem.

·         The subject of the police service dealing with an excessive number of welfare issues was raised.

The Committee was advised that figures had reduced and data was available to support this.  It was acknowledged that being in police custody was not the most appropriate place however, if they were not in custody it would also cause issues for the individual until more appropriate service could be provided.

·         One of the identified risks in the business plan was that the Health Board had stopped contributing to S.117 placements in residential care.  The Committee asked how much of a problem this was for the Authority.

The Executive Board Member for Social Care and Health advised that there was a legal agreement across Wales that the Health Boards contributed, however in Carmarthenshire the Health Board had stopped their 50% contribution for residential care for older people services.  Negotiations were on-going with the Health Board.  The Head of Mental Health and Learning Disabilities advised that the Health Board argue that the support is being provided by visiting nurses and that residential placements was not necessary.  It was hoped that this issue could be rectified with taking legal action.

·         Reference was made to the Public Accountability Measures and the rate of people kept in hospital while waiting for Social Care. It was asked if this was due to the number of staff vacancies.

The Interim Head of Integrated Services stated that vacancies was not the cause and explained that the timing of how the figures were validated only showed a snap shot for that timeframe. The Committee was re-assured that the Authority had a good patient flow from hospital and currently there was only one patient waiting for care.

·         Concern was expressed regarding the satisfaction results for adults satisfied with their care and also for carers that felt supported.

The Performance, Analysis and Systems Manager advised that the figures were not bad and that the wording of some of the survey questions were ambiguous.  The Q4 Complaints and Compliments report would provide more information regarding the survey results.  The recent CIW report also confirmed that users were happy with the service.  The Interim Head of Integrated Services advised that Welsh Government had stopped the survey however the Authority would continue with surveys to enable any issues to be monitored and resolved by the Authority.  It was also stated that 84.6% was a good satisfaction result.   The Committee was reminded that the commissioning team undertook stringent monitoring and review of care provisions.

·         Reference was made to a recent Community Health Council meeting, where a presentation was provided on the discharge process. Officers were asked to provide further information regarding the process.

The Interim Head of Integrated Services confirmed that progress was being made on the 4 pathways and that further information would be circulated to the Committee.

UNANIMOUSLY RESOLVED that the Communities Departmental Business Plan 2020 – 2023 be received.