Agenda and draft minutes

Councillor Gareth Lloyd Davies declared a personal interest in items 8 and 9.

Councillor Emrys Wynne declared a personal interest in items 6 and 7.

To appoint a Vice-Chair of the Partnerships Scrutiny Committee for the municipal year 2017/18 (role description attached).

In accordance with the Council’s Constitution, nominations were requested for the office of Vice-Chair of the Partnerships Scrutiny Committee.

Councillor Huw Williams nominated Councillor Emrys Wynne, seconded by Councillor Gareth Lloyd Davies.

RESOLVED that Councillor Emrys Wynne be appointed Vice-Chair of Partnerships Scrutiny Committee for the ensuing year.

No urgent matters had been raised.

To receive minutes of the Partnerships Scrutiny Committee meeting held on 22 June 2017 (copy attached).

9.35 a.m. – 9.40 a.m.

The minutes of the Partnerships Scrutiny Committee held on 22 June 2017 were submitted.

At this juncture, the Chair extended her thanks to the Committee Administrator for the excellent minutes.

RESOLVED that the minutes of the meeting held on 22 June 2017 be received and approved as a correct record.

To consider a report by the Community Safety Manager (copy attached) and comment on the activity of the Joint Community Safety Partnership in 2016-2017 and the Local Priorities for 2017-2018.

9.40 a.m. – 10.20 a.m.

Councillor Emrys Wynne declared a personal interest as he sits as a JP in North East Wales.

Prior to discussion, members were informed by the Chair that the Committee was acting in its capacity as the Council’s designated Crime & Disorder Committee in accordance with sections 19 and 20 of the Police and Justice Act 2006.

The Lead Member for Corporate Standards introduced the report (previously circulated) which detailed the activity and performance of the Joint Conwy and Denbighshire Community Safety Partnership (CSP) during 2016-17 and outlined the Partnership’s priorities for 2017-18. 

The Community Safety Manager briefed the Committee on the background to the establishment of community safety partnerships along with their statutory roles and responsibilities.  She drew members’ attention to the priorities set by CSPs on a regional basis and the local priorities set by the joint CSP for progression in Conwy and Denbighshire. All of which were listed in the report.  Appendix 1 to the report contained the actions identified with a view to delivering both local and regional priorities, whilst Appendix 2 detailed the Partnership’s performance with their delivery.

During her introduction the Community Safety Manager highlighted the following points:

·       the reduction during the year in acquisitive crime and in adult and youth re-offending rates, all of which was extremely positive.  Central government had provided funding to CSPs to specifically focus on these areas, therefore there had been a correlation between the targeted approach and the reduction in the figures;

·       there had been an increase in number of incidents of crimes against persons, such as anti-social behaviour (ASB), reported during 2016-17.  This was partly attributable to the fact that the definition of violent crime now included a person pushing another individual over or knocking them down;

·       unfortunately there had been a number of well publicised incidents of violent crime in Denbighshire during recent months.  The CSP’s role when such incidents occurred was to focus on low level work within the communities e.g. improve lighting, provide safety messages on how to keep safe etc.  The larger agencies, such as the Police and Fire and Rescue Service undertook the investigative work;

·       all actions in the action plan had either been delivered, or were on track to be delivered.  There had been a delay with respect of receiving data from the Fire and Rescue Service with regards two of its initiatives, this had been attributed to changes in personnel.  The CSP had nevertheless been assured that both initiatives had exceeded the set targets;

·       the CSP’s work spanned a wide-range of crime and disorder matters from anti-social behaviour to environmental crime, rural crime to international terrorism, low level petty crime to serious crimes against persons and properties;

·       in relation to the Welsh Government’s (WG) dashboard exercise regarding terror prevention, there was one area which the CSP required to strengthen.  That area related to educating the public to know how to respond if they were caught up in a terrorist incident whilst at home or away from home;

·       the problems relating to ASB in and around Rhyl Railway Station had improved greatly following the utilisation of Supporting People funding.  The funding provided services to individuals who were known to be causing problems in the area.  The problem would probably never be eradicated, but the situation had improved in recent years;

·       work was being undertaken with a number of agencies with a view to dovetailing services to address problems caused by substance misuse in both Conwy and Denbighshire.  Whilst this work was reaping benefits, more still needed to be done to address the problem;

·       incidents of fly-tipping in the West Rhyl area had improved  ...  view the full minutes text for item 6.

To consider a report by the POVA Co-ordinator (copy attached) to provide Members with an overview of the impact of Local Safeguarding arrangements and practice and to review progress in this key area of work over the last twelve months.

10.20 a.m. – 10.50 a.m.

The Head of Community Support Services introduced the Protection of Vulnerable Adults (POVA) Co-ordinator’s Annual Report on Safeguarding Adults in Denbighshire for 2016-17 (previously circulated). 

He explained that the presentation of the report to the Committee, which gave an overview of the impact of local safeguarding arrangements, fulfilled the Service’s statutory requirements to report performance in this extremely important, sensitive and high risk area to members.  The report detailed the number of adult protection activities in Denbighshire which, similar to other local authority areas, was increasing year on year.  In addition it detailed the county’s performance in meeting the national performance indicator and developments during the year to the Safeguarding Team, which had strengthened considerably.  It also gave an update on the position regarding Deprivation of Liberty (DoLS) applications during the year. 

During his introduction the Head of Service advised that all local authorities across Wales had received a letter from the Care and Social Services Inspectorate Wales (CSSIW) regarding the Inspectorate’s concerns in relation to adult safeguarding work.  A meeting with CSSIW’s Chief Inspector and DCC’s Chief Executive to discuss local issues was scheduled to be held in the near future. 

Members were advised that of the total number of POVA referrals received during the year, in excess 75% of them had not met the Adult Protection Threshold to merit further investigation.  The quality of referrals and the threshold set were regularly quality assured to make sure that they were fair and equitable to all parties.  Hospitals were also involved with this work.

In response to members’ questions the Head of Service:

·       confirmed that the continual increase in the number of Adult Protection referrals and DoLS applications placed pressure on the Service and made meeting target dates extremely difficult.  The ultimate aim upon receipt of any referral was to ensure the vulnerable person’s safety, meeting targets was secondary;

·       if at any time he was concerned about the Service’s capacity to safeguard vulnerable individuals he would flag the risk up to the Corporate Executive Team (CET) to seek financial/resource assistance;

·       advised that whilst statistics showed  over 50% of the alleged abuse had been perpetrated by a ‘paid employee’ and had taken place in a ‘care home’ setting’, it was important to remember that these were ‘allegations’.   This was a national trend in relation to POVA statistics.  It was also important to bear in mind that workers in care home settings were delivering very intense personal care and could, therefore, be more susceptible to allegations being made against them.  The number of allegations proven following an investigation was far lower;

·       described the escalation process followed upon receipt of an allegation, emphasising that the capacity of the Council’s contract monitoring team had been strengthened during the year to support the investigation process;

·       confirmed that all adult safeguarding referrals were required to be acknowledged and  enquiries made within 7 days of receipt.  Nevertheless, if the allegation was of a serious nature, which put an individual’s safety at risk, it would be dealt with urgently on the day of receipt;

·       confirmed that safeguarding training was mandatory to all staff who undertook paid employment as in the care sector;

·       agreed with members that recent awareness raising in respect of adult protection matters had probably contributed towards the increase in the number of referrals.  However, this was not viewed as a negative consequence if it meant that all vulnerable people were kept safe; and

·       advised that the Service had sufficient resources this year to meet POVA duties and DoLS demands.  A presentation would be given to all elected members during the autumn on the Social Services  ...  view the full minutes text for item 7.

At this juncture (10.40 a.m.) there was a 15 minute break.

The meeting reconvened at 10.55 a.m.

To consider a report by the Principal Manager, Community Support Services (copy attached) providing an update on the progress to date in developing community arrangements to support timely discharges from hospital.

11.00 a.m. – 11.30 a.m.

Councillor Gareth Lloyd Davies declared a personal interest as he is an employee of Betsi Cadwaladr University Health Board (BCUHB).

The Head of Community Support Services introduced a report by the Principal Manager – Community Support Services (previously circulated) which updated the Committee on the progress made to date in developing community arrangements to support timely discharges from hospital in Denbighshire. 

The report which the Committee had requested provided information on:

·       Delayed Transfers of Care (DToC), Discharge and Flow;

·       Step Down Cluster and Step Down Team;

·       Work with and to support Care Homes;

·       Current community activity to support timely discharge through prevention;

·       Future plans and pilots; and

·       Regular and improved communication

During his introduction the Head of Service informed members that during the first quarter of 2017-18 there had only been one DToC case in Denbighshire on the specific ‘census days’.  The establishment of the Single Point of Access (SPoA) service and the Step Down Cluster and Team approach had helped to improve performance in this area, but more importantly to help individuals to return home with sufficient appropriate support.  Other services which had contributed greatly towards the reduction in DToC was the availability of the Advanced Nurse Practitioner Service and a 24 hours a day, 7 day a week District Nursing Service.  It was pleasing to report that the local authority and the Betsi Cadwaladr University Health Board (BCUHB) were continually working together at all levels to remove all barriers and strive for better seamless services.  Nevertheless, there were still certain aspects of health and social care work which were proving difficult to surmount i.e. pressures on domiciliary care services in the rural south of the county.  BCUHB’s Assistant Area Director of Therapy Services emphasised that prevention work was key to alleviate pressures on hospitals and other acute services. 

During the discussion Committee members:

·       welcomed the integrated approach taken by both Health and Social Care services towards supporting patients’ discharge from hospital and ensuring that relevant services were in place to support them once discharged, including dementia sufferers; and

·       welcomed the aspiration in the Well-being Impact Assessment (WIA) to deliver integrated health and social care services which met the Welsh Language Standards.

Responding to points raised by the Committee both Health and Social Care officers:

·       confirmed that they were experiencing difficulties in recruiting sufficient numbers of Welsh speakers in certain health/social care disciplines to meet the aspiration set out in the WIA, domiciliary care was one of these areas;

·       advised that they worked closely with local schools and colleges with a view to promoting careers in both Health and Social Care services;

·       workforce development was being progressed on a regional basis under the guidance of Gwynedd Council’s Director of Social Services;

·       explained in detail the Step Down process for hospital discharge and the supporting of an individual’s independence at home; and

·       outlined the effectiveness of the Community Resource Team in Rhyl, and their plans to rollout this integrated services approach to other parts of the county in due course, including Denbigh, Prestatyn and Ruthin.

At the conclusion of the discussion the Committee:

RESOLVED subject to the above observations, to:

(i)               congratulate both Health and Social Care Services on the work undertaken to date to support timely discharges from hospital; and

(ii)             support future plans and pilots, within hospitals and the community, which were aimed at improving outcomes for individuals

To consider a report by the Head of Community Support Services (copy attached) providing Members with information regarding existing and future pooled budget arrangements between Denbighshire County Council and Betsi Cadwaladr University Health Board.

11.30 a.m. – 12.00 noon

Councillor Gareth Lloyd Davies declared a personal interest as he is an employee of Betsi Cadwaladr University Health Board (BCUHB).

The Head of Community Support Services introduced the report (previously circulated).  He advised that the report, which outlined the Council’s experience in relation to establishing and operating two ‘pooled budget’ arrangements with the Health Service, was being presented to members at their request.  This would be ahead of the requirement to establish and operate a ‘pooled budget’ between both partners for the commissioning of residential care services.  The residential care services ‘pooled budget’ required to be established by April 2018 in accordance with the provisions of the Social Services and Well-being Act (Wales) 2014. 

The ‘pooled budget’ arrangements outlined in the report related to the Community Equipment Service (CESI) and the Health and Social Care Support Workers (HSCSW) Service.  Arrangements for both services were detailed in the report along with the relevant legal background for their establishment. It also contained information on financial matters, governance issues, stakeholder views on the effectiveness of the ‘pooled budget’ arrangements and lessons learnt by both partners when planning for future larger ‘pooled budget’ arrangements.

At the conclusion of the report’s introduction BCUHB’s Assistant Area Director of Therapy Services advised that with respect of the CESI arrangements, patients now received a seamless service, which promptly delivered the health or social care equipment they required to support their independence.

In response to members’ questions Health and Social Services officers:

·       advised that a wider range of equipment would now be available from CESI.  When the Service was established items such as ‘pressure mattresses’, which were supplied by the Health Service at that time, were not available.  However, over the years the Service had evolved and Health Service monies which had been held in a variety of departmental budgets had been released into the ‘pooled budget’.  This had assisted CESI to expand to supply all types of health and social care equipment;

·       gave an overview of the prices of certain types of equipment, which varied greatly;

·       confirmed that used equipment returned to CESI was assessed, serviced and cleaned by specialists before it was issued to other individuals.  ‘Amnesties’ had also been held enabling people to return equipment, to the Service, that was no longer required;

·       each individual’s needs would be assessed by health/social care professionals before a determination was made on which equipment/aids would assist and support their care and independence; and

·       confirmed that the monies put into the existing ‘pooled budgets’ by both Health and Social Care services was not additional funding given to them for this purpose.  It was money granted to both services as part of their overall budget which the services had earmarked for either equipment of HSCSW work.  By pooling these funds together it helped both Health and Social Care to increase their ‘buying’/’commissioning’ power for equipment and services.  In addition, some surplus grant monies, if appropriate could be vired into a pooled budget, depending upon the grant’s initial purpose   

The Committee:

RESOLVED to receive the information provided in relation to the establishment and operation of current ‘pooled budget’ arrangements between Social Services and the Health Service, including the lessons learnt from those experiences as the Council prepared to enter into future mandatory ‘pooled budget’ arrangements in accordance with the requirements of the Social Services and Well-being (Wales) Act 2014.

To consider a report by the Scrutiny Coordinator (copy enclosed) seeking a review of the committee’s forward work programme and updating members on relevant issues.

12.00 noon – 12.15 p.m.

The Scrutiny Co-ordinator submitted a report (previously circulated) seeking Members’ review of the Committee’s work programme and provided an update on relevant issues.

During the discussion it was:

·       Agreed to add Denbighshire’s Homelessness Strategy 2017-21 and the Supporting People/Homelessness Prevention Plan 2018/19 to the work programme for 2 November meeting

·       Agreed to defer SPOA (Single Point of Access) item to the 14 December 2017 meeting

·       Agreed to invite the relevant Cabinet Lead Members to future meetings of the Committee for items pertinent to their portfolios

·       Agreed to a 9.30 a.m. briefing with the Partnerships Scrutiny Committee meeting to commence at 10.00 a.m.  This would be on trial basis from the November 2017 meeting.

RESOLVED that subject to the changes in the Forward Work Programme agreed during the meeting, the work programme, as detailed in Appendix 1 to the report, be approved.

To receive any updates from Committee representatives on various Council Boards and Groups.

12.15 p.m. – 12.20 p.m.

None.

The meeting concluded at 11.50 a.m.