Agenda item

To receive the review conducted by Audit Wales in to the Commissioning of Older People’s Care Home Placements by North Wales Councils and Betsi Cadwaladr University Health Board (copy enclosed).

David Wilson -  Audit Wales representative, introduced the regional report (previously circulated) to members. He informed members the regional work had been carried out to assess how partners worked together and separately in the commissioning of care home placements for older people. The field work was conducted in February/ March 2021. He informed members Councils and Health boards were responsible for commissioning car home placements they do so within legislative and policy frameworks set out by Welsh Government. Key messages from the research was drawn together and illustrated the framework was encouraging a way of working that was impacting on health and social care professionals and the people that they served. From this research Audit Wales conducted two reports- one for Welsh Government and the second for North Wales Councils and Betsi Cadwalader University Health Board.

Members were guided through the main concerns raised by Audit Wales during the review. It was stressed Audit Wales had challenged Welsh Government to look at some of the key legislative requirements as they undertake a review of current policy to resolve some of the concerns raised from the Audit Wales report.   

In conclusion the Audit Wales representative stressed the importance for partners to review the role they play in the process. Members need to be assured that public money was being spent wisely and work towards working building a more sustainable care sector with provision for the type of care needed.

Members heard 5 recommendations had been presented to Councils and Health Boards. Members were guided through the recommendations as set out in the covering report. All the reports produced by Audit Wales and Officers had been attached to the agenda for members information.

The Interim Head of Community Support Services guided members through the management response to the proposed recommendations detailed in the reports. He guided members through the proposals and officers responsible. It was stated the review of the pre-placed agreements would take some time, with the restrictions resulted from Covid work is taking a bit longer. Members were reminded that there was a number of alternative to residential and nursing care for the residents.

The Lead Member for Wellbeing and Independence thanked the Audit Wales for the report. She stressed to members the local pressure of staffing levels in the care sector.

The Chair thanked all officers for the detailed report and appendices. It was very well detailed and provided members with a lot of information.

The following points were discussed in further detail:

·         A number of processes were undertaken to produce the findings of the report. Communication with authorities was vital to achieve an agreed outcome and recommendations. An emphasis on the role Welsh Government policy and legislation was stressed within the report.

·         It was noted within the report a number of positive, good practice areas was found. As a region a number of areas were demonstrating good practice and potentially sector leading in areas. The relationship with providers across a large geographical area and complex system was very good. Officers felt the second draft was more demonstrate of the positive aspects and more of a balanced review.   

·         A previous report had been presented to committee on pooled fund arrangements. An arrangement was in place which Denbighshire administrated. Quarterly the other local authorities and health board completed a transfer for the amount of money they had spent on residential and nursing care. The funds were then sent back to each party from Denbighshire. Denbighshire received funds to cover the administration of costs. The arrangement is very complex and difficult to explain to a member of the public. The Audit Wales representative stated included in the report to Welsh Government had been a challenge for them to make it clear to the public sector the benefits of such arrangements.  The Corporate Director stressed both the complexities and positive aspects of pooled budgets.

·         Members noted the complexity around the structure chart that fits around the operation of the RPB. Part of the complication was due to North Wales being one of the biggest RPB’s with 6 local authorities and a health board.

·         Placements in neighbouring authorities and England does happen, the aim is always to place individuals close to family if placements are available.  Officers stressed the importance of communication between the family, individual and practitioner took place and account of all opinions.

·         A report on the development of the new population needs assessment had been presented to Scrutiny and then reported to Cabinet. Providing members the opportunity to comment on the assessment.

·         The risk register reflects the issues raised in the report. It was felt the issues raised were well sited issues around commissioning, the workforce and having resources. Members were informed in addition to the corporate risk register there was a service risk register which the Interim Head of Community Support Services reviewed on a regular basis.   

The Chair thanked all the officers for the detailed response to members concerns. It was noted a lot of work had been undertaken with the reports both to Welsh Government and North Wales Councils and partners.

RESOLVED that members note the recommendations made by Audit Wales within the report. Members requested that regular updates be presented to the Committee when a detailed update is available.