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An apology for absence was received from County Councillor E Roderick.
There were no Declarations of Interest from Members relating to items to be considered on the agenda.
The Committee did not receive any disclosures of prohibited party whips which a Member had been given in relation to the meeting in accordance with Section 78(3) of the Local Government Measure 2011.
The Chair was authorised to sign the minutes of the previous meetings held on 2 March 2022 and 29 June 2022 as correct records.
Documents Considered: · Annual Report of the Director of Social Services. Issues Discussed: · The report had been compiled by the former Director who has recently left the Council and was for the period April 2021 to March 2022. · One of the ongoing themes was the continued impact of the Covid pandemic and increased demand as well as delays in residents accessing treatment. · This had an impact on staff in terms of recruitment and retention. · Whilst the Service had come out of business continuity on 16 May 2022 but the pressures which had existed to that point remained and were exacerbated due to the cost of living increases and the impact on the war in Ukraine on the economy. This has not only affected Council services but also service providers. · Questions: Question Response Can you provide an update on the pressures for providers in recruiting staff particularly in Domiciliary Care and where are the challenges. The most significant pressures are around recruitment and retention. Feedback from external providers is that staff are feeling fatigued, and as covid has eased, staff have chosen to be recruited to work in other sectors which has been a significant pressure on the market. Work has been undertaken with the sector around innovative ideas to see how we can support these organisations, attracting people into the sector, provide electric vehicles, and support with fuel pressures. Whilst things have relatively stabilised this is still a significant pressure and the Service is continuing to work with the sector Is this a national pressure It is, but the pressure is seen more significantly in Powys due to rurality of the county. There is anecdotal information that staff are feeling that it is not affordable to work in that profession. Do carers get paid for their travelling time and how much are they paid per mile. Yes they are paid for travelling time as part of the Powys pledge introduced last year. The pledge is a mechanism where organisations sign up to improve the terms and conditions of the workforce and part of that is to pay for travelling costs. The travel costs are currently 35p per mile. Most organisations are signed up to the silver pledge at the moment. The Gold pledge is being presented to Cabinet to request an increase to 45p per mile which is the HMRC rate. The 45p also provides parity with internal staff rates. Morale is very low and we are losing staff due to mileage rates and hours of working. It is of concern that we will lose staff. What else is being done within the workforce to ensure staff well-being is being considered and are there any other schemes or programmes being considered. Could we use two carers travelling together in an area which could save on mileage and reduce the stress of staff. The morale in the sector is generally is very low and this is supported by feedback from the sector. There has also been a significant reliance on agency staff. One of the strengths coming out of the pandemic is a better partnership approach between organisations, although pressures are still being felt. Work has been undertaken to consolidate runs and rationalise where possible to reduce travelling costs. Longer term we have the Social Care Academy which will help the workforce in future. The work being undertaken now on the Powys pledge, reducing fuel costs and other ways to support the sector are things we need to do immediately. The proposal to Cabinet is to increase mileage rates to 45p to be reviewed in 12 months’ time. There are some things which the Council can do locally but we are also dependent on decisions taken nationally. The Council is very mindful of the effects of last two years on staff and are trying to stabilise the market but this is a national issue but exacerbated in Powys due to the rurality and the costs of travel. Do we still have schemes set up to signpost staff to support services such as the PTHB Silver Cloud and mental health support i.e. a well-being hub for internal staff. Support is available to staff across the whole of the Council. There is the corporate well-being offer (Care First) available to all staff for general well-being support as well as counselling services. In care services there are some bespoke well-being support services such as mindfulness. The cost of living and recruitment and retention has been recognised as a corporate risk. There are wider discussions at a corporate level about addressing these issues which might include a market comparison exercise comparing pay and conditions against other Welsh authorities. In terms of cost of living consideration is being given to whether staff can claim expenses back sooner given the increase in fuel costs. Do staff get paid for travelling time as well as mileage Yes but not for the commute to work. In terms of well-being roadshows have been undertaken to meet staff. One of the key aspects highlighted was around the ways of working. Staff are finding working from home increasingly more isolating and difficult. There is a need to consider how these services work in future so staff have opportunities to be working together more and have access to senior staff for advice. Therefore a more agile working arrangement is required which mean staff can get together as well. Appraisals are important for staff as well as team meetings, one to one’s and support and supervision for new staff. Mindfulness sessions will be ongoing. The Directors assured the Committee that they will be engaging and listening to staff and this is a priority. Are the staff forums, roadshows or face to face The employee representatives group meets every 6 weeks and every team is asked to send a representative. We try to avoid managers coming as they have other opportunities to speak to senior managers so we seek people from all levels of the organisation. There is an opportunity for the group to raise issues and talk about problems and also solutions and share good practice as well as having the opportunity to speak to Directors and Heads of Service. Is there anything in the report you would wish to highlight to Councillors in respect of Children’s Services for example placements and in particular residential placements. How have things moved over the year and are we in an improving position. There are three key pressures on the service namely increased demand, deficit in workforce availability and placements. The placements situation across the UK is still difficult as there are not enough places. Work has been undertaken with regulators and also working to try and address the deficit in the numbers of places over the past few years. We are making progress and we have a children’s home in the South and have purchased a property in the North. Also, additional properties have been allocated to the Service from Housing to set up new children’s homes which will help long term but will take time to implement. A property in the South is being prepared for one young person coming out of a specific placement. However, it will not meet CIW requirements currently as it does not have a fire suppression system which is causing a delay. We also have children in the wrong placements which does not work for the child, staff and the community where the young person is living. Members are asked to support the approach as there is no other way as we have seen the impact when the Council is at the mercy of the market. There will be an improvement in the numbers of looked after children and capacity next year as work comes to a fruition. In respect of Child Protection figures there has been a huge increase in numbers between April 2021 to March 2022 of over 65%. Is this trend continuing this year and are we seeing the same level of increase. What does that look like now and the impact on staffing and the risks. There has been a big increase in child protection numbers. We have put in some senior management oversight of this area of work to keep this under review. On the whole the ratios of where work is going has remained the same. However, we do not want children on the child protection register unless they need to be there as that has an impact on staff. A child goes onto the register following a multi agency panel decision. Once a child is on the register there is much for the Service to do to keep the child safe and this is where risk is most heightened. This can include supporting families to make changes so that the child can stay with their family. There is senior management oversight of decisions undertaken. A review of how statutory agencies are working together is being undertaken currently. We are also asking multi agency professionals to consider the risk and resources available and whether we can work with families at the lowest level possible. Whilst demand has increased this has not translated into increased numbers of children on the register. Do the difficulties faced in Children’s Services increase the level of risk to which children are exposed. Are we at the capacity of what we can handle. We have been in that position where things have been critical and a summit was held in March between managers and the Director to look at risk and resources and what we can do to manage the risk within available resources. We have been in this crisis situation for some months. We looked at the way things could be changed, drawn down covid pressure resources, and increased capacity in the teams. We set in place the 3R’s plan and we are in a recovery phase and have been reshaping and things are going to plan but there are a number of positions in the service which are funded temporarily for what we hoped would be a temporary increase in demand. As the increase demand has continued, we are now looking at how the service can be reshaped, as demand is unrelenting at the front door. We are reviewing whether we have the capacity in the right place within the service and what else we need to do. A paper to scrutiny and Cabinet will set this out. We have looked at every possible option to stretch the resource within the service in both Childrens and Adults Services and where possible and bring in temporary support or managed services. It is not a matter of insufficient funding but insufficient qualified staff professionally and domiciliary care staff nationally. The Chief Executive commended the Head of Childrens Services for her contribution in stabilising and leading the Service since joining the Council. Outcomes: · Report noted. · Is the comparison exercise with other Councils is undertaken could scrutiny see the final report on the exercise. · The Committee asked for a Member Development Session in relation to the Adults and Childrens budget.
Documents Considered: · Presentation by Sali Campbell from PTHB. Issues Discussed: · In 2018 Welsh Government invited significant bids from Partnership Board which would enable integrated health and social care services in Wales. · Based on the data showing the greatest need and distance to services Newtown was selected as a hub for the North of the county. · This is a health and well-being hub which will provide more day services than are currently available. It also aims to reduce travelling for customers who otherwise would have to go to hospitals in Shropshire. · This would integrate health and social care and introduce a new model of care which is being developed. · This is not a new hospital but will provide an enhanced level of diagnostic services than currently available, more day facilities for treatment than is currently possible. · Other facilities are planned to be on the same site such as the primary school. A new library will also be built as part of the new facility. Supported living was to have been provided but that is available now elsewhere in Newtown. · Questions: Question Response What are the Powys Together sessions focussed on. They are focussed on early help and low level intervention. The focus is on reducing the need for statutory services. One question raised previously about the site is how safeguarding will be assured in terms of the location of the school and also services. The school will be designed in accordance with normal practice with safeguarding built into the project so will be fully secured with fencing in place. This will be incorporated into the wider planning proposal. Dafydd Llwyd is shown on the plan but the school moved some years ago Yes it is correct that Dafydd Llwyd moved to a new building some years ago. The building has been used recently for the integrated family centre for Newtown and also partially for Childrens Services. What is the purpose and scope of the Academy and what’s going to happen to the library, as it’s Powys’ best library. In relation to the Academy, the Academy seeks to ‘grow our own’ workforce and offer in house, education, support and training to upskill and recruit staff. Ongoing conversations are being held with the college about how the Academy can complement what the college is providing. There is an Academy just opened in Bronllys and this is about development of the future workforce. This will be a satellite to Bronllys in Newtown and we are looking how we further train staff with Aberystwyth University. What will happen to the library. Will it remain as it is or will it provide books for this learning. The current library will be replaced by a new facility which is more integrated with the school and the Academy. This is a really inspiring project. How might this project be linked or connected to the Regional Skills Partnership. The RSP will be involved with the Academy as the project progresses and the Academy will also link in with the wider skills programme in the region. How does the health and care provision proposed for this site compare to those delivered at Glan Irfon in Builth Wells. Some individuals in the area are not impressed with the services offered from Glan Irfon. There is a focus on learning from elsewhere both internally and externally, which is going through an approval mechanism focussing on the external. We have also been focussed on internal learning looking at examples such as Glan Irfon and the integrated care teams in Ystradgynlais and what can be learned from those projects. What is proposed for Newtown by comparison to Glan Irfon is focussing on getting the service delivery right before anything is built and people brought together for the facility. Also learning lessons from the past. When we deliver new or integrated services they are fine when you have the expertise to deliver them. The problem arises when you lose some of those skills and those services cannot be re-delivered. Is skills enhancements and succession planning being considered for the future by the council and PTHB. The workforce futures programme operating between the Council and PTHB is trying to address these issues and trying to address issues about recruitment and retention currently by removing barriers and in the future. There are also good examples of integrated health care facilities in the UK and Wales such as the ones in Aberaeron and Cardigan. As this grows how will this be the North Powys Hub and not just the Newtown hub and how services reach into North Powys. Have there been discussions in terms of working streams. If we are bringing services to Newtown rather than people have to travel out of the county for services that will be good. Transport will feature in discussions in the future as well. A travel times analysis is to be undertaken by PTHB, which will show the distance individuals currently travel to access services and the cost of that. Then we need to look at where people need to travel to access the service quicker such as Aberystwyth from Machynlleth or go to Newtown. The offer is about delivering services for all of North Powys not just Newtown. The Newtown element is the third sector community hub aspect where the community helped to shape that. The campus is a North Powys offer. It is important that people do not have to travel long distances to see consultants. The concern is that services delivered locally at community hospitals will not be relocated to Newtown once the facility opens. The fine detail has not been agreed as yet and what services are to be provided from Newtown and when services are determined that is when engagement needs to occur. Outcomes: · Presentation Noted. · The Committee will need to focus on where it can have the best focus such as on collaborative work. · The Committee could also consider establishing a Working Group to look at this work in future. · Add the scrutiny of the Health Academy to the Committee’s Forward Work Programme. · If the lessons learned exercise has been completed can this be included in an future presentation to the Committee.
The Committee considered establishing the following Working Groups: North Powys Well-Being Hub: The following Members indicated an interest in this Working Group: County Councillors G Preston, G Jones Children’s Services: The following Members indicated an interest in this Working Group: County Councillors G Jones, L Rijnenberg, J Wilkinson, B Breeze, J Ewing Adults Services: The following Members indicated an interest in this Working Group: County Councillors C Robinson, G Preston, G Morgan, C Walsh, J Ewing. The Chair indicated that she would be involved in both the Childrens and Adults Working Groups. The Chair asked if Members could advise her and the Scrutiny Officer of their interest in sitting on a working group by 5th August, 2022.
Documents Considered: · None. Issues Discussed: · The Committee suggested that the following items be added to the Forward Work Programme for consideration: · Working Group – North Powys Well-Being Project · Review of Travelling Rates for carers. · Learning from previous projects e.g. Glan Irfon included in next North Powys Well-Being Project presentation. · Workforce, Recruitment, Grow your own and retention · Self Assessment items. · Residential placement figures for children · Day Centres. · Provision for adults with learning difficulties + developmental occupation. Also look at what services are available to adults with learning difficulties. (Adults WG) · Relationship between front door child protection and numbers of children going into children’s services. · Extra Care Facilities for Adults – also links to older people’s facilities. What progress is being made on this. · Monthly performance reports on Childrens and Adults – to be circulated to Members on Teams for the Committee to comment upon · Trends over the past few years for the Services – question to Emma Palmer. · Future development on prescribing art Outcomes: · Draft Work Programme Noted. · Add items to the work programme.
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