Agenda and minutes

To receive apologies for absence.

Apologies for absence were received from Cllrs Edwin Roderick, Benjamin Breeze, Elwyn Vaughan, Richard Church (Cabinet Member for a Safer Powys), Lynette Lovell (Director of Education and Children), Jane Thomas (Head of Finance/Section 151 Officer) and Wayne Tannahill (Associate Director of Capital, Estates and Property, PTHB).

To receive declarations of interest from Members.

The Committee received the following Declarations of Interest from Members relating to items to be considered on the agenda:

·       County Councillor Chris Walsh declared a personal interest relating to items 10, 11 and 12, due to being an Independent Member of Powys Teaching Health Board.

·       Nina Davies (Director of Social Services and Housing) declared an interest due to being an Associate Member of Powys Teaching Health Board.

To receive disclosures of prohibited party whips which a Member has been given in relation to the meeting in accordance with Section 78(3) of the Local Government Measure 2011.

(NB:  Members are reminded that, under Section 78, Members having been given a prohibited party whip cannot vote on a matter before the Committee.)

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.

(i)       To authorise the Chair to sign the minutes of the previous meeting held as follows as a correct record:

(ii)       To receive and consider the Action Log.

Documents Considered:

• Draft minutes of the Health and Care Scrutiny Committee meeting held 3^rd November 2023.

Observations and Recommendations:

• Proposed by County Councillor L Rijnenberg and seconded by County Councillor C Walsh, the Committee moved to authorise the Chair to sign the minutes of the previous meeting as an accurate record.

To receive and consider the report of the Cabinet Member for Finance and Corporate Transformation.

Documents Considered:

• Strategic Risk Management Report – Quarter 2 (2023)

Background:

• During Quarter 2 there were 15 risks listed on the Strategic Risk Register which were contained within Appendix A of the report. The summary of the strategic risks within a heat map was contained within Appendix B.
  • The remaining strategic risk was withheld from the public report due to the need to preserve commercial confidentiality.
• The report provided assurance updates for each strategic risk from the relevant risk owner and Service Area.
• The heatmap (Appendix B) showed that:
  • Five out of the 14 strategic risks were rated as likely having a major impact.
  • EDR0011 was rated as almost certainly having a major impact.
  • ASC0064 was rated as likely having a severe impact.
• The Strategic Equalities and Risk Officer noted the strategic risks relating to health and social care, namely strategic risk ASC0064 – “Welsh Community Care Information System (WCCIS) is not fit for purpose, then it will impact upon service area’s ability to carry out our statutory operational duties”.
  • The impact rating for ASC0064 increased from major to severe, which equated to an increase from a residual rating of 12 to 20.
• The Strategic Equalities and Risk Officer reported additional strategic risks relating to health and care, including:
  • ASC0066 - If a Social Care provider(s) fail then the pressure on care homes, domiciliary care providers, supported living and other providers would become unsustainable.
    • Residual rating reduced from 20 to 12.
  • ASC0071 - If there is insufficient capacity to respond to the longer-term demand in Adults' services in timely manner.
    • Residual rating of 9.
• Cabinet was requested to deescalate strategic risk PCC0008 – “If planned power outages (rota disconnections) occurs then it may affect our ability to deliver services”.

Issues Raised by the Committee and Responses Received:

To receive and consider a report of the Director of Social Services and Housing.

Documents Considered:

• Corporate Safeguarding Board Activity Report

Background:

• The Director of Social Services and Housing provided the Committee with an update on the work of the Powys Corporate Safeguarding Board, for the meetings held 4th August and 15th September 2023.
• Nine actions were rated as ‘green, on-track’ and one as ‘amber, slightly off track’.
  • The amber recommendation related to expectation of contractors in respect of safeguarding training.
• The annual safeguarding self-assessment audits were discussed by the Board.
• A dashboard had been created which allowed the actions to be monitored and progress tracked. Work was ongoing by Heads of Service to update their actions.
• The Board were shown a presentation about the implementation of a tiered approach to contract management, and prioritising resources for contracts.
• There were discussions around Channel and Community Safety Partnership agreement arrangements. It was agreed that officers would undertake work around proposals, which would be fed back to the next Board meeting in December.
• Safeguarding Theme of the Month – the Board were informed that Spotlight on Safeguarding Communications had started, with regular updates and communications released.
• A safeguarding conference hosted by Powys had taken place, with a focus on rural safeguarding.
• White Ribbon Day walks had been held across Powys.
• Reports by exception were received from Housing, Education and regarding safeguarding training for Adult and Children Social Care.
• The Volunteering for Powys County Council policy was included for the Board’s information and noted that it had been approved.
• The Board were informed that 98.5% of Members were compliant with mandatory safeguarding training, with mitigating circumstances for the 1.5% non-compliance.
• A safeguarding vlog was discussed and would be provided to the Board at the meeting on 14^th December 2023. The following meeting was scheduled for 14^th March 2024.

Observations and Recommendations:

• Committee Members reviewed the scrutiny action tracker and were satisfied with the Director of Social Services and Housing’s responses to the previous actions, relating to the link contained within the Corporate Safeguarding Board Activity Report not working.
• The Chair confirmed that following a request from the Committee, both the Chair and Vice-Chair attended the National Safeguarding Conference. The Chair wished to formally note that the event was well organised with innovative presentations on best-practice.
• The Chair noted the presentation provided by the New Zealand group, She Is Not Your Rehab, and asked that the Committee be updated if similar initiatives on intergenerational trauma, violence and abuse were to be discussed at a Welsh-level.
• There were no other questions from Members.

To receive and consider a report of the Cabinet Member for a Caring Powys.

Documents Considered:

• Winter Pressures (2023) Cabinet Report

Background:

• The Head of Adult Services provided an overview of the Winter Pressures report, which was presented to the Cabinet on 14^th November 2023.
• The Head of Adult Services noted that what were previously considered winter pressures were now being seen throughout the year, with increased demand and complexity impacting on care and support options.
• Specific details were requested regarding hospital discharges. A range of support options were needed to ensure admissions were reduced; to keep people living in their own homes for as long as possible; to reduce delay discharges and the length of stay in hospitals, which should delay the need for more enhanced care and support.
• The report noted there were a significant number of people waiting for more timely assessments. The Head of Adult Services assured the Committee that new operational processes provided increased and enhanced capacity through a managed agency. There was now around 100 people awaiting allocation, which was a significant drop from 300 people waiting in September 2023.
• As a result of the changes to the operational processes, there had been a decrease in the number of people being delayed from hospital discharge due to social worker assessments.
• It was important to note the unique factors and demography of Powys which pressured social work teams and health colleagues, due to the absence of a district general hospital. Staff needed to travel to a number of hospitals around Powys’ border which dispersed resources due to the travel time involved.
• Consequently, during crisis periods, staff needed to attend more escalation meetings to manage demand and allocate resources effectively.
• Compared to the rest of Wales, Powys had more people waiting for domiciliary and residential care, there was also a lack of nursing beds available in the county. Work was ongoing within the Commissioning and Partnerships Service to develop these care markets.
• The number of people awaiting domiciliary care had decreased, however it was important to note that in September 2023, more than 800 hours of extra domiciliary care were provided compared to the year before which was not meeting the demand.
• Mitigations included reviewing how the Council operated by enhancing the locality model, allocating resources in the right place at the right time.
• Work continued with third sector partners and with Powys Teaching Health Board to develop the Home First and reablement programme.
• A review was expected into the reablement programme, to ensure it was fit for purpose.
• Social work capacity had increased as well as trailing different roles in the social work teams with discrete functions. For example, having officers dedicated to carers assessments and hospital discharges which had seen a significant reduction in delays, thus allowing risk to be managed more effectively.
• Conducting the first of a two-week review into the ‘perfect week for discharges’, which included the Council, third sector, Health Board colleagues reviewing the discharge process, to ensure it was as efficient and effective as possible.
• The escalation process had been reviewed to ensure  ...  view the full minutes text for item 7.

To receive and consider a presentation from Powys Teaching Health Board.

Documents Considered:

• ‘Better Together’ presentation provided by Powys Teaching Health Board (PTHB).

Background:

• The PTHB Assistant Director – Transformation and Value provided Committee Members with a presentation around joint working and the accelerated sustainable model.
• The PTHB Interim Chief Executive noted that both the Council and Health Board experienced shared challenges across Powys relating to demands on services, workforce and finances.
• The long-term, health and care strategy had been in development since 2017, which set out to establish a clear vision on how public sector organisations within Powys would work together, with a focus on well-being and shared service delivery.
• A joint executive team between the Council and Health Board had been established, there had also been agreement to consider how joint working could inform Sustainable Powys.
• A copy of the presentation slides were provided and were available to view within the agenda pack.
• The Director of Social Services and Housing noted that in addition to working with PTHB, the Regional Partnership Board also had a role in linking with other partner organisations operating in Powys. There was a focus on prevention, Home First, person-centred rebalancing, in addition to finding digital solutions and incorporating place-based planning.

Issues Raised by the Committee and Responses Received:

To consider passing the following Resolution:

RESOLVED to exclude the public for the following items of business on the grounds that there would be disclosure to them of exempt information under categories 2 and 3 of The Local Authorities (Access to Information) (Variation) (Wales) Order 2007).

The Monitoring Officer has determined that categories 2 and 3 of the Access to Information Procedure Rules apply to the following items. His view on the public interest test (having taken account of the provisions of Rule 14.18 of the Council's Access to Information Rules) was that to make this information public would disclose information relating to the financial or business affairs of any particular person (including the authority holding that information).

These factors in his view outweigh the public interest in disclosing this information. Members are asked to consider these factors when determining the public interest test, which they must decide when considering excluding the public from this part of the meeting.

The following motion was proposed by County Councillor C Walsh and seconded by County Councillor G E Jones, the Committee therefore:

RESOLVED to exclude the public for the following items of business on the grounds that there would be disclosure to them of exempt information under categories 2 and 3 of The Local Authorities (Access to Information) (Variation) (Wales) Order 2007).

To receive and consider a presentation from Children’s Services.

The Head of Children’s Services provided a presentation to Committee Members regarding the work of the Therapeutic Attachment Team.

To receive and consider a presentation from Powys Teaching Health Board.

The Strategic Planning Manager provided a presentation and updates regarding the North Powys Wellbeing Hub.

To receive and consider a confidential Strategic Risk.

The Head of Commissioning and Partnerships provided an update regarding the confidential strategic risk RCPCH0007 and reported that the issue surrounding the strategic risk had been resolved. Formal de-escalation of strategic risk RCPCH0007 would therefore be sought from Cabinet.

To note the scrutiny forward work programme.

Documents considered:

·       Health and Care Scrutiny Committee Forward Work Programme 2022-2027

Background:

• The Health and Care Scrutiny Committee work programme was included in the agenda pack for the Committee to note, and to consider any additional items for inclusion.

Observations and Recommendations:

• The Chair and Vice-Chair had previously met with the Scrutiny Officer to review the work programme.
• The work programme would be considered by the Committee at the end of the meeting.