Agenda item

To consider a report by the Principal Manager: Business Support, Community Support Services, which details the key issues arising from the Care and Social Services Inspectorate Wales (CSSIW) evaluation of Denbighshire Social Services performance for 2014-15, had been circulated previously.

                                                                                                            9.35 a.m.

A copy of a report by the Principal Manager:  Business Support, Community Support Services (PM:  BS - CSS) had been circulated with the papers for the meeting.

The Corporate Director: Communities (CDC) introduced the report and explained that the evaluation was based on a wide-range of evidence from the Council, regulators and service users.  On the whole the Regulator’s evaluation of the Council’s Social Care Services was a positive one, with just a few areas for improvement identified.  The main areas on which the Care and Social Services Inspectorate Wales (CSSIW) would be regularly liaising with the Council on during the current year with a view to ensuring they would be strengthened or progressed were:-

·                     The changes to the senior management infrastructure for the delivery of social care and their impact upon children and adults;

·                      Protection of Vulnerable Adults (PoVA) – improving the timeliness and engagement of PoVA and undertaking a review of threshold levels

·                     Quality monitoring of all domiciliary care providers (including obtaining service users’ views and experiences of the services); and

·                     Integrated partnership working with the Betsi Cadwaladr University Health Board (BCUHB)

The CSSIW’s Regional Director for North Wales outlined to the Committee the main points highlighted in the Regulator’s report.  In addition to the areas listed above which required strengthening she advised that:-

·                     A recent Wales Audit Office (WAO) national study had concluded that greater use of Telecare and assistive technology was needed across Wales, therefore the Regulators would be monitoring the situation across the country;

·                      With respect to the need to improve the quality monitoring of domiciliary care providers, the Council would need to have regard to a national report due to be published in the spring of 2016 when developing this aspect of its work;

·                     The 38% increase in the uptake of direct payments for people with learning disabilities or mental health needs was commendable;

·                     Profiling of people with mental health was an area for improvement across the North Wales region.  Clarity was required around the identification, assessment and commissioning of services;

·                     Denbighshire had an exceptionally high number of people with learning disabilities, often with complex needs, from outside the county living within its boundaries.  They mainly resided in accommodation run by independent providers, a number of which had been established following the closure of the former North Wales Hospital.    As a number of the residents were from outside Denbighshire there was a risk that they were not at present known to either health or social care services, but there was likely to come a time when they would need to access primary health and social care services and require the protection of the Council’s safeguarding services.  There was therefore a need for the Council and its partners to assess potential future pressures on their services;

·                     The Council’s prevention and early intervention approach through various teams working within the Children and Family Services had resulted in a significant drop in referrals and re-referrals to the Service.  Nevertheless there was a need to track and monitor outcomes for children and families signposted to other services;

·                      As the non-contributory respite care for children with disabilities had now ended there would be a need to monitor whether some families were opting out of receiving respite care on financial grounds, and the consequential impact that was having on the entire family;

·                      There would also be a need to monitor access and outcomes for children and families who were currently not meeting the threshold to directly access support from Children’s Services – the new National Outcomes Framework (currently being piloted by Denbighshire) would assist with this aspect;

·                     Whilst there were improvements with respect to services offered to Looked After Children (LAC) more work was required with respect to ensuring regular health and dental checks for LAC and in relation to forward planning and outcomes for young people leaving care.;

·                     The National Outcomes Framework pilot in the county seemed to be working well; and

·                     The Regulator was satisfied with the leadership and the governance of social care services in the county – it was of the view that the service challenge process and scrutiny of the service provision was robust

Responding to Members questions officers and the CSSIW’s Regional Director advised that:-

·                     Large clusters of independent care provision for people with intensive/complex needs learning disabilities were not in-keeping with the intended ethos of the closure of the former mental health institutions;

·                      The provisions of the Social Services and Well-being (Wales) Act 2014, when they come into force in April 2016, would strengthen powers relating to information sharing;

·                     There was a need to put the SPoA Service on a more secure financial funding, it was currently heavily dependent upon grant funding.  There was also a need to grow the service to include more partners/stakeholders, currently it was Health, Social Care and the voluntary sector that were involved in the service.  One potential future partner could be the Police Service;

·                     the Council took its responsibilities with respect to safeguarding both children and adults extremely seriously.  One of the objectives of the current re-structure of the Community Support Services was to strengthen aspects of safeguarding.  In addition a peer review had been undertaken with Conwy County Borough Council and measures identified as part of the findings of that review would be embedded in the service, as would the findings of the WG’s Operation Jasmine Review.  Designated Lead Managers had also been subject to specialist confidence building training and the new post of Safeguarding Team Manager would be crucial in taking a professional lead in the area of safeguarding;

·                     Part 6 of the Social Services and Well-being (Wales) Act 2014 should help with regards to securing better educational outcomes and forward planning for LAC, as would the policy change around ‘When I’m Ready’.  However, Denbighshire already had a similar policy with respect to determining the most appropriate time for a young person to leave care, called ‘Staying Put’, this would require some refinement to bring it in line with the new legislation.  A LAC nurse had been appointed during 2014/15 and this had improved performance with respect to ensuring that LAC were registered with a GP and Dentist;

·                     Denbighshire was the first local authority in North Wales to establish a SPoA Team.  This joint team between Health, Social Services and the voluntary sector has a ‘What Matters’ conversation with individuals and their families/carers to establish the type of support required and to signpost them to other relevant services or organisations.  A formal evaluation of the SPoA Service had been undertaken recently and it had concluded that it was a good, valuable service which benefitted residents.  The service conformed with the requirements of the new Social Services and Well-being (Wales) Act 2014 requirements.  Good working relationships already existed between social care staff and district nurses and work was currently underway with a view to fostering similar relationships with third sector staff and therapists.  This would help identify any service gaps;

Discussion took place around the value of 15 minute ‘check calls’ to service-users in their own homes.  It was emphasised that there was no expectation for those who undertook these calls to administer care.  However, when commissioning care packages the Council had to have regard to the individual service users’ views on the type of care they required.  The national study into domiciliary care which was currently underway would look at all aspects of domiciliary care e.g. length of calls, travelling time between calls, continuity of care/carers etc.  When determining the future domiciliary care contracts and the monitoring of those contracts the Council would need to have regard to the findings of the national study.

The Committee was advised that Partnerships Scrutiny Committee had already scheduled into its forward work programme for February 2016 a report examining PoVA matters and a report on the ‘Independence of Older People’.  It was:-

RESOLVED – that, subject to the above observations and the fact that Partnerships Scrutiny Committee had already scheduled reports on aspects of the areas identified for improvement in its forward work programme, to receive the CSSIW’s Annual Evaluation and Review of Denbighshire’s Social Services for 2014/15, and the Council’s associated Action Plan.