Agenda item

The Committee considered the draft Annual Report of the Statutory Director of Social Services on the Performance of Social Care Services in Carmarthenshire 2020/21.  Members were informed that there was a statutory requirement for the Director of Social Services to report annually on delivery and performance, as well as plans for the improvement of the whole range of social services. 

The report detailed the progress made on areas identified for improvement in last year’s report and highlighted those areas to be developed in the current year.  It examined each service area within Social Care and showed how service strategies, actions, targets and service risks would be addressed and delivered operationally by the service this year, based on the approved budget.  The report also set out the challenges due to COVID 19 and highlighted the areas to be developed in the current year.

The report outlined how the service performed in 2020/21 together with an assessment on the future, together with strategic priorities for 2021/22.  It linked closely with the Business Plans for the Directorates of Community Services and Education & Children’s Services.

Following publication of the report, Care Inspectorate Wales (CIW) and the Welsh Government would complete their analysis and review of the report.  There would be a formal meeting with CIW in October to discuss their analysis and proposed plan.  This will be followed by an Annual Letter to Council in late November/early December, confirming their analysis and inspection plan.  The process will link in closely with the Wales Programme for Improvement and the Annual Letter from the Wales Audit Office.

The Director of Community Services stated that the report had been challenging to write and drew the committee’s attention to the statutory notice dated June 1^st, 2020 which detailed that he had been unable to assure Council of being able to provide properly functioning social care services. The lack of PPE combined with the impact of the virus on residents in care homes, care staff and families were major concerns which had not been helped by the lack of timely guidance provided by Public Health Wales.  It was noted that the care home system had been hours away from collapsing with four private care homes unable to operate without intervention from the authority.

Credit was given to the care sector workforce in maintaining statutory visits and consistently delivering during a challenging time. It was summarised that it had been a difficult year but with extraordinary response and good outcomes considering the situation.

A number of questions were raised to which the Director of Community Services responded.  The main matters were as follows:-

·         It was asked what the current situation was with care homes.

The Director of Community Services stated that there were no issues with the supply of PPE and that care home residents were above 90% double vaccinated and that evidence indicated that the workforce and residents were being protected by the vaccination.  It was noted that the occupancy rate was much lower than expected and that financial support received from Welsh Government had covered the voids, however, funding would likely be phased out in September.  Recruitment was a constant challenge, but Carmarthenshire had not experienced issues to the degree that neighbouring authorities had.  The Director of Community Services hoped that (not withstanding Public Health Wales guidance) care homes visits would soon return to normal. However, it was noted that caution was still required and that it was a trade off between the right to see family / social connection and protecting the wider care home.

·         A question was asked how the lack of PPE at the start of the pandemic had impaired the work of staff in general.

The Director of Community Services stated that there had been a global supply chain issue.  There had been a period where masks cost £7 / 8 instead of pence.  It was expressed that policy issues and delay in guidance from Public Health Wales had meant that on occasions equipment couldn’t not be supplied.  Assurance was provided that planning for future variants was well advanced.

·         It was stated that there should be more local vaccination centres due to residents in parts of the County having to travel a significant distance to the showground. 

The Head of Integrated Services advised that the Health Board had a mobile vaccination unit which was currently being used to target areas where uptake of the vaccination was low.  It was indicated that as the facility was already available there may be scope to roll out the use of this unit in more remote areas of the County.

·         It was asked what lessons had been learnt from the last 18 months and if there was a review being undertaken nationally or by Welsh Government regarding the impact of the pandemic on care homes.

The Director of Community Services advised that he was not certain on what reviews were being undertaken by Welsh Government but that a National review would be welcomed. Assurance was provided that the authority had undertaken its own detailed study. 

·         Concern was expressed regarding the apparent blanket approach to DNR for residents in care homes at the start of the pandemic.

The Director of Community Services advised that in his opinion the DNR process wasn’t always followed, and that more engagement should have been undertaken with patients and families to enable them to make informed decisions. During this time collaborative working with the Health Board and the senior team meant that the issue had been resolved.

UNANIMOUSLY RESOLVED that:

·         the Draft Annual Report of the Statutory Director of Social Services on the Performance of Social Care Services in Carmarthenshire 2020/21 be received,

·         the authority write to Welsh Government requesting a review of the issues experienced in care homes during the pandemic.