Wrthi'n llwytho
Y penderfyniadau fel y mae cofnodion y cyngor yn eu cofnodi. Bydd crynodeb mewn iaith glir yn dilyn pan fydd wedi'i ysgrifennu.
RESOLVED- That the minutes of the previous meeting of the Social Care and Health Overview and Scrutiny Committee held on 20 July 2022 be approved and signed as a correct record.
RESOLVED- That the Social Care and Health Overview and Scrutiny Committee Forward Work Programme, together with the combined Forward Work Programme be approved.
An apology for absence was received from Councillor Sue Shotter (Chair).
None.
None.
Y penderfyniad fel y'i cofnodwyd
RESOLVED- That the minutes of the previous meeting of the Social Care and Health Overview and Scrutiny Committee held on 20 July 2022 be approved and signed as a correct record.
The minutes of the previous meeting of the Social Care and Health Overview and Scrutiny Committee held on 20 July 2022 were submitted for approval. RESOLVED- That the minutes of the previous meeting of the Social Care and Health Overview and Scrutiny Committee held on 20 July 2022 be approved and signed as a correct record.
Y penderfyniad fel y'i cofnodwyd
RESOLVED- That the Social Care and Health Overview and Scrutiny Committee Forward Work Programme, together with the combined Forward Work Programme be approved.
The Scrutiny and Committee Services Officer presented Members with the individual Forward Work Programme (FWP) for the Social Care and Health Overview and Scrutiny Committee, together with the combined FWP. The following changes were highlighted: · The Social Care and Education Development Programme had been deferred to January, 2023. · A report on the Glan yr Afon Residential Building had been scheduled for October 2022. · The review of the action plans for the Audit Wales Social Services reports had been deferred to November 2022. · Representatives from Betsi Cadwaladr University Health Board (BCUHB) would provide an orthopaedic programme update on 30 November 2022. · Confirmation was awaited as to when the More than Just Words (previously known as Welsh Language in Residential and Nursing Homes) update would be presented. · It was likely that the Workforce Retention and Recruitment update would be presented in January 2023. RESOLVED- That the Social Care and Health Overview and Scrutiny Committee Forward Work Programme, together with the combined Forward Work Programme be approved.
Councillor Paul Luckock asked the Cabinet Member for Integrated Adult and Community Services the following question: More adults and older people are being deprived of their liberty, Deprivation of Liberty Safeguards. The proportion of applications that are for urgent authorisations- under which the provider self-authorises the deprivation of liberty with the local authority under a duty to check this within seven days is placing significant demands on all involved. What actions/decisions have you taken since May, 2022 to ensure internal controls are robust and effective record keeping is taking place in all circumstances? How many urgent authorisations have been refused? Have the Inspectorate and Audit Commission been specifically monitoring this locally? The Cabinet Member for Integrated Adult and Community Services provided the following response:- In 2007 the Mental Health Act (1983) was amended and the Deprivation of Liberty Safeguards (DoLS) Code of Practice was launched in March 2009. The DoLS Team in Conwy County Borough Council (CCBC) was a small resource with four Best Interest Assessors and a Co-ordinator. There was currently a shortage of Section 12.2 Doctors, who undertook mental health assessments, determining the eligibility for deprivation of liberty orders. CCBCwas facing recruitment issues, and it had taken 8 months to secure a Best Interest Assessor. Additionally, CCBC had a high proportion of care homes for all people requiring care, treatment and accommodation. The team were also responsible for completing assessments for Conwy residents, who were placed throughout the UK in areas such as Luton, Hexam and the Isle of White. The DoLS authorisation lasted a maximum of 12 months (unless the resident moved or circumstances changed) and required a full re-assessment to gain re-authorisation. The team had to prioritise demand, which was done using the tool created by the Association of Directors of Social Services (ADSS) Cymru to ensure consistency across Wales. This included urgent authorisations given by Providers prior to referrals for standard authorisation assessments. Unfortunately, not all urgent authorisations were appropriate and were confused with poor care planning, safeguarding and those individuals who were in receipt of end of life care where the order would be extremely intrusive. Since May 2022, the team had declined six authorisations where eligibility had not been met. Assessments were undertaken as per the priority tool with robust record keeping and scrutiny of assessments. Care Inspectorate Wales received quarterly monitoring information from the team. The Liberty Protection Safeguards (LPS) would supersede DoLS in the future, which was a more proactive process, embedding Mental Capacity and Deprivation of Liberty into the routine assessment, to establish the need for care, treatment and accommodation so that the authorisation was in place as the individual moved into the care homes. This process would therefore negate the current position whereby standard and urgent referrals from care homes were sent to the DoLS team post admission. In accordance with the Constitution, Paul Luckock asked the following supplementary question: Is there capacity to do anything more going forward? The Head of Service - Children, Families and Safeguarding advised that many inappropriate referrals were received and that from May 2022, 6 referrals had not been progressed.
The Corporate Programme and Project Manager presented a report on the establishment of a new programme of work - Transforming residential placements for children and young people in Conwy County. Appendix 1 of the report, included a Programme Brief, outlining the background, objectives, outline business case, deliverables and anticipated benefits of the programme.. The following points were highlighted: · The programme was responding to the significant pressure on the Looked After Children Independent Placements budget, where the allocated budget had been exceeded. · Over the last 5 years there had been an increase in both the number of placements required and the cost for independent placements. · The purpose of establishing the programme was to bring together existing, in development and new options/proposals for residential placements under one coordinated programme of work. With a focus on residential provision for children and young people, which included: - Alternative emergency overnight placements - Short term assessment - Medium term transition - Long term permanence - 16+ semi-independent provision · Successful delivery of the transformation would involve the use of programme and project management best practice and the appointment of a dedicated Transformation Lead Officer. · To ensure that the programme of work was supported and had governance arrangements in place, it was proposed that it would form part of the existing Social Care and Education Service Development Programme, which had accountability to oversee and support the delivery of key service changes. · The Programme Board included the Service Portfolio Holders, representation from Social Care and Education Scrutiny Committees and had representation from each political group. Thanks was extended to officers for the comprehensive report. In scrutinising the report, Members discussed the following: · A mixed economy of provision was welcomed. · It was suggested that an understanding of care pathways and which internal controls were working effectively was required. - In response, the Service Manager - Looked After Children advised that care pathways had been explored and that a Strategic Multiagency Panel met on a monthly basis. - Early intervention had been looked at in order to seek to minimise the amount of children reacquiring a placement. - Care plans were reviewed regularly. · Concern was raised in respect of the lack of price mechanisms within the report. - In response, the Corporate Programme and Project Manager advised that as there was high demand for services this had an impact on cost and placements had to be found quickly. - The programme would seek to address supply and demand challenges by considering various options. · Further information was sought in respect of the high costs associated with placements. - In response, the Service Manager - Looked After Children advised that staff costs were included. - It was difficult to obtain a clear, detailed breakdown from providers and that a Local Authority provision would allow for more control over spend. - As there was a shortage of placements, it was often not possible to negotiate costs and contracts. · A Placement Strategy Submission had been presented to the Welsh Government (WG) and additional funding may be available in respect of the Transformation Lead position and to accelerate development of the programme. · It was queried as to how risks associated with the programme would be mitigated. - In response, the Corporate Programme and Project Manager advised that the project management approach was being used and that engagement was taking place with relevant officers. - It was acknowledged that ongoing staff capacity was a challenge. · It was suggested that the Programme Board required a more diverse membership. · Due to robust regulations now being in place, it was suggested that placements should be managed in house by Conwy County Borough Council (CCBC). · CCBC had a good working relationship with providers, which was essential as extra provision was required due to there not being enough placements available within North Wales. · The Cabinet Member for Children, Families and Safeguarding made reference to workshops, which would be held to discuss the programme of work and would be open to all Members. RECOMMENDED TO CABINET: a) That the programme to transform residential placements for children and young people in Conwy County be endorsed. b) That the programme of work be included within the existing governance structure for the Social Care and Education Service Development Programme.
The Service Manager for Commissioning and Quality Standards, Social Care presented the North Wales Social Care Market Stability Report – 2022. The purpose of the report was to provide an overview of the North Wales Market Stability Report 2022 (MSR), which had been produced regionally as a requirement of the Social Services and Wellbeing (Wales) Act 2014. The following points were highlighted: Adult Residential Services • The number of people aged over 65 in North Wales increased by 17% between 2010 and 2020 and was projected to increase by a further 20% over the next 20 years. This was likely to increase the demand for care and support. • An estimated 64% increase was expected between 2017 and 2035 in the number of people living with dementia in North Wales. • Conwy County had the highest number of registered Adult Care Homes in North Wales at 73 with almost 1,500 available placements. • Finding the right balance for fee levels was very challenging in the current climate. • Current vacancy rates in adult residential services were low in Conwy County compared to other Local Authorities, because of the shortfalls in the Domiciliary Care market. • It was recognised that there was a shortage of Welsh language provision in the residential care sector. Domiciliary Care Services • The MSR anticipated an increased demand for domiciliary care services in North wales and Conwy County. Conwy County Borough Council (CCBC) was already the largest commissioner of Domiciliary Care Services in North Wales, with almost 14,000 hours per week. • More than 90% of Domiciliary Care Services in Conwy County was provided by the independent sector, however the sector was struggling and not able to meet the current demand, because of staff shortages. • The MSR report recognised the importance of the Third Sector with examples such as, community navigators and social prescribing models mentioned. Children’s Residential Services • CCBC were experiencing challenges in sourcing appropriate local placements for children with complex needs. • There was a need for additional and appropriate short-term care arrangements and facilities for children. • Children aged 16+ often had complex needs and placement options were limited. • The cost of children’s residential services had increased significantly with an over reliance on a small number of independent providers. • Respite provision for children with disabilities was accessed at Llys Gogarth and was a resource much valued by parents and carers. Fostering Services • The number of children in foster care in North Wales had increased year on year, but despite a proactive recruitment campaign there was still a shortage of foster carers. Adoption Services • There were more children waiting for adoption than there were adopters available. • The MSR report identified challenges around the ability of current service provision though the Welsh language. Unpaid Carers • The MSR report acknowledged the vital role of unpaid carers. • Unpaid carers could find it difficult to find alternative care and take a break with a shortage of short term respite provision. Vital services, such as day centres, had been closed during the pandemic. Advocacy Services • The report accepted the importance of advocacy services, but didn’t provide any assessment of the demand or market stability. This was an area for improvement in future assessments. In scrutinising the report, Members discussed the following: • The 1500 care home places within Conwy County were taken up by residents from all over the UK and in particular those from neighbouring authorities. • Information was sought in respect of the 1000 hours of care that were not being covered. - In response, the Strategic Director of Social Care and Education advised that a capacity plan was being developed in respect of ongoing pressures. - Different models were being explored in respect of domiciliary care. - A report would be presented to the Committee in respect of recruitment within the sector as well as a review of pay and terms and conditions for carers. - Care responsibilities were increasingly being taken on by families and care homes and residential facilities were being utilised. - Recruitment was ongoing in respect of the Reablement Team. • It was queried as to whether staffing issues within the care sector was likely to be a permanent problem. - In response, the Strategic Director - Social Care and Education advised that it would take time for the situation to improve. - Funding was required in order that better pay could be offered to attract and retain carers. - Conwy County had a high number of older residents, however, the Welsh Government (WG) settlement did not reflect this. - A national pay structure for carers was required. - A career in care was a vocation and was not necessarily driven by pay. - WG were discussing the creation of a career pathway for carers. • Reference was made to the possibility of recruiting from abroad. - In response, the Strategic Director - Social Care and Education advised that consideration must be given to the Welsh language and culture. - Some authorities were trialling international recruitment, however there was no equivalent care qualification. - Brexit had contributed to the shortage of care staff. • It was suggested that a rigorous assessment of price mechanism was required. • It was suggested that unpaid carers be recruited to care for their loved ones in the hope that they may remain within the profession. RECOMMENDED TO CABINET That North Wales Social Care Market Stability Report – 2022 be recommended to Council for approval.
Rhaid i gynghorwyr ddweud pan fydd ganddyn nhw gysylltiad personol â rhywbeth sy'n cael ei drafod, fel swydd, eiddo neu aelod o'r teulu. Mae buddiant sy'n rhagfarnu yn ddigon cryf i'r cynghorydd adael yr ystafell fel arfer a pheidio â chymryd rhan.
Caiff datganiadau eu darllen o'r cofnodion unwaith y byddan nhw wedi'u cyhoeddi.
Yn rhestru cynghorwyr presennol y cyngor yn unig. Nid yw aelodau cyfetholedig, swyddogion a chyn-gynghorwyr yn cael eu dangos.