Issue - decisions

Cabinet Member for Health and Social Care (EH) introduced the report (previously circulated), summarising the significant increase in the need for social care services, issues over recruitment and retention to the sector, thus progress being slower and performance against key indicators having dropped because of the pressures. Focus ahead would be on the transformation agenda.

Corporate Director: Social Services and Education (NS) explained the report’s production was a statutory requirement and its format and contents were prescribed by Welsh Government, therefore there were limits to how Denbighshire County Council could adapt the report. However, there would be a new format soon from Welsh Government.

Corporate Director: Social Services and Education (NS) expressed her thanks to the department, partners and informal carers for their continued hard work. The team continued to operate as a blended service with Education and Social Care and had joint heads of service and a joint budget and service plan.

The Chair then opened the discussion out for questions. 

Responding to members’ questions the officers advised:

• Recruitment and retention throughout the report was cited as a challenge, particularly in relation to Children’s Services. The difficulties faced here were not new for this reporting period the issue has been reported to scrutiny numerous times. The department had done further specific targeted work, looking at the reasons provided in exit interviews, developing the staff currently employed, and continuously promoting the flexible working offer and lobbying nationally for pay increases to the sector.  However this was a national issue, Social Work was now undersubscribed and therefore not enough newly qualified entrants were coming in to the profession. Similarly with Mental Health, there was a national shortage of professionals in the service.  Denbighshire was looking at the current structure within the team and allocating work to free up Approved Mental Health Practitioner’s (AMPH’s) to focus on the work they were statutorily required to undertake.
• Corporate Director: Social Services and Education advised that she and fellow members of the Association of Directors of Social Services (ADSS) Cymru were continually lobbying the Welsh Local Government Association (WLGA), the Local Government Association (LGA), both UK & Welsh Governments and others with respect of better pay for care sector workers, including parity of terms and conditions with National Health Service (NHS) employees.
• The report was onerous, Head of Adult Social Care and Homelessness (AL) was working with Welsh Government on the new format for future annual reports, however it was uncertain how much of their input would be taken onboard. The new format should hopefully be better, it would include a performance section with data and would separate Adult and Children Services information more clearly. The Case Studies provided within the report were well received and provided useful illustrations of the complexities entailed in providing the right types of services to suit the individuals.
• Digital inclusion was discussed and the importance of reaching out to older residents and those that were digitally excluded was discussed.  The ‘Ageing Well in Denbighshire’ scheme played a crucial role in this, especially in rural Denbighshire. ‘Digital Confidence’ was another scheme aimed at building digital confidence, this programme was funded by Shared Prosperity Fund (SPF) monies.
• Complex Needs, the pressures continued to increase, older population presenting to residential care now on average were 82 – 83 years old and were using these services when families could no longer provide the required support, therefore their needs were greater when entering care. In Children’s Services since the pandemic there had been an increase in complex mental health and behavioural mental health. A lot of work was ongoing with partners, Children and Adolescent Mental Health Services (CAMHS), Local Integrated Family Team (LIFT), Betsi Cadwaladr University Health Board (BCUHB) Mental Health Services, Police etc. focussing on early intervention and supporting families earlier. Regular Multi Agency Team (MAT) meetings with schools were held, also the Team Around the Family (TAF) approach was utilised, and lots of sharing of information and data took place to support effective collaborative working.
• That there had been a dip in performance, this was due to the complexities of need with which individuals were presenting which meant that assessments were taking longer, however the service wanted quality driven assessments undertaken and therefore these took more time. Recruitment and retention was another factor which contributed to the decline in performance, as well as a new system of recording data which meant it was difficult to compare one year to the next.
• The report illustrated that only six complaints had been received against the Service, which seemed an extremely low number. The complaints procedure was a statutory process defined by Welsh Government. The Denbighshire County Council Complaints Department was highly regarded and had been approached by a number of other authorities on how to deal with complaints in an effective manner.  The department’s response rate to complaints was extremely efficient.
• Homelessness was within the Head of Adult Social Care and Homelessness’ (AL) remit, however the requirements for the Director of Social Services Annual Report did not necessitate information on homelessness to be included in the report. Within the finance section for information £4m of the £59m Adult Services budget was for the provision of homelessness services, the remainder of Homelessness Services were funded via grant funding. Aged 16-17 homeless young people formed part of the Children’s Service Budget so is not included in this figure.
• Transitioning from Children to Adult Services was all about forward planning and early intervention. For children with disabilities, Denbighshire County Council had an excellent onward planning process. However, for Children with Mental Health entering Adult Mental Health services the department were experiencing some pressures. Care Leavers if in education stayed within the service until they were age 21 up to 25. There was bespoke transition, work with homelessness, onward housing and what was available could be problematic, therefore the Service was currently looking at ways to develop support within the home. For 18-year-olds in residential care there was a step-down transition out to supported accommodation. For residential and fostering there was a programme called “when I’m ready” which meant that they did not have to leave just because they had turned 18.  A lot of pathway planning, managing money and budget skills were key aspects for this age group.
• Not for Profit agenda – Denbighshire’s Head of Children's Services served on the All-Wales Directors of Children’s Services board for this particular programme as its Chair.  There were a lot of unanswered questions around this Bill, a number of questions had been submitted to Welsh Government in relation to it.  Whilst the intent of the ‘Not for Profit’ agenda was commendable it would in reality be extremely challenging, and it was still not clear where exemptions would be made.
• Micro providers had filled a lot of gaps in domiciliary care provision in the county, it was regarded as a valued offer by Denbighshire County Council as the services provided by micro-providers stopped people requiring statutory services by helping them maintain their independence. Each micro-provider could have up to four people for whom they could provide support and care. In total micro providers provided care and support for circa 200 residents, some of which was self-funded. Denbighshire, recruited, trained and supported Micro-providers, however they were very much a private entity, self-employed individuals.
• Global Resettlement Team was funded through the Home Office via funding for specific Resettlement Programmes for citizens from Afghanistan, Syria and Ukraine. Financial support for Ukrainian citizens was diminishing, however, there were still a lot of Ukrainian families living with host families across the county and they continued to receive funding via the Home Office. The Ukrainian Welcome Hub had now closed, with all families being accommodated in more permanent housing solutions. Denbighshire had a limited number of Afghan and Syrian families coming through each year, numbers were very small. With respect of Asylum Seekers, in 2023/24 each local authority were given an allocation of homes that could be used to accommodate asylum seekers.  The provider for the Home Office approached the Council with properties they were proposing to be used for this purpose and how they would be brought up to standard. Funding for these was a one-off amount per bed space.  There were currently three or four families housed in Denbighshire and the Global Resettlement Team worked closely with North Wales Police (NWP) and Denbighshire’s Public Protection Department in relation to Asylum Seekers. No care funding is used for the resettlement programmes.
• Looking to the near future, the position would be challenging, Social Services were not immune from significant budget savings, performance would decline in some areas, the support offer would probably need to be less, however every effort would be made to maintain service delivery for the most vulnerable.

At the conclusion of an in-depth discussion the Committee thanked the Director for a comprehensive report which provided an honest account of the Services’ performance, along with the pressures it encountered in delivering quality services to the County’s residents during austere financial times. 

The Committee:

Resolved:  subject to the above observations -

(i)  to receive the report and endorse it as a clear account of the Council’s Social Care Services’ performance in 2023/24; and

(ii)  to acknowledge the financial and resource pressures within which the Services were currently expected to operate. 

The Committee adjourned for a break at 11.20am and re-convened at 11.30am.