Agenda and draft minutes

Venue: Council Chamber - County Hall. View directions

Contact: Lisa Richards 

Items
No. Item

1.

Apologies

To receive apologies for absence.

2.

Declarations of Interest

To receive declarations of interest from Members.

Minutes:

There were no declarations of interest.

 

3.

Disclosure of Party Whips

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.)

Minutes:

There were no disclosures of party whips.

4.

Minutes pdf icon PDF 307 KB

To authorise the Chair to sign the minutes of previous meetings on 13 and 27 January 2020 as correct records.

Additional documents:

Minutes:

Documents:

·         Notes of meetings held on 13 and 27 January 2020

 

Discussion:

·         There was some confusion regarding statements made in the minutes of the budget meeting of 27 January 2020.  A revised form of words would be drafted with the Corporate Director (Children’s and Adults)

 

Outcomes:

·         The Chair was authorised to sign the minutes of meetings on 13 and 27 January 2020 as correct records

 

 

Members were concerned regarding the extensive agenda and how effectively it could be scrutinized.  It was suggested that any agenda should be limited to two or three substantive items otherwise appropriate scrutiny could not take place.  The Chair reported that he had raised the issue with the Co-ordinating Committee.

5.

North Powys Project - Model of Care pdf icon PDF 299 KB

To consider the proposed Model of Care for the North Powys Project.

Additional documents:

Minutes:

Documents:

·         Report of the Corporate Director (Children and Adults)

·         North Powys Wellbeing Programme – Model of Care

·         Impact Assessment

 

Discussion:

·         A high level, extensive consultation with the public, staff and wider stakeholders had been carried out

·         The next steps of the programme would see a more detailed design of the Model of Care developed

·         The Model would be the delivery vehicle for the joint Health and Care Strategy approved in 2017.

·         A key focus of the programme is around delivering care closer to residents’ homes and aims to keep residents as independent as possible for as long as possible

·         There had been concern via engagement feedback that dementia did not have a section of its own, but it was considered under the wider issue of mental health

·         Similar issues had been raised regarding younger disabled adults – the view is that the Model covers Start Well, Live Well and Age Well and single groups should not be singled out at this stage

·         There had been criticism that the Model was too medicalised – the language had been adjusted but it was not possible to remove all medical terms

·         The Citizens’ Pledge had been revised to soften the language regarding expectations of citizens

·         The Project Manager was asked whether a desk top exercise had been carried out, the validity of the exercise and how many residents had been engaged in the process – engagement reports have been completed and were available to any Member

·         The programme was ambitious and the level of risk was also questioned, for example whether it would be possible to recruit an adequate workforce etc – a risk register was in place behind the programme with workforce being one of the greatest risks.  Workforce issues would become more apparent as a more detailed case is prepared and would be supported by a Workforce Strategy and plan.  The right resources need to be in place to deliver better outcomes.  Demand may also change if the prevention and wellbeing programme is effective.

·         The programme intends to develop a campus approach incorporating education, housing etc

·         The medicalisation of the Model was also a cause of concern.  Within the document people are viewed as ‘patients’ which was not thought to be appropriate in a high-level document.

·         The components of the Model are not described on an equal basis

·         The Health and Care Strategy underpins the programme and the proposal must not be seen as provision of new medical facilities in Newtown

·         Some elements were not mentioned at all

·         It would be necessary to engage with all residents and ensure that there was awareness that the project was not exclusively for Newtown

·         A bid for capital funding for site development would be made to the Welsh Government

·         There is the potential for savings to be made and for the project to be delivered within the existing revenue budget.  In time, the programme will influence demand as early intervention and wellbeing increases.  There could also be a change to the type of services  ...  view the full minutes text for item 5.

6.

Performance REports

6a

Adults' Performance Report - December 2019 pdf icon PDF 654 KB

To consider the December 2019 Performance Report for Adult Services.

Minutes:

Documents:

·         Adult Services Performance report as at 31 December 2019

 

Discussion:

·         The service was in a good budget position and was projecting a balanced budget at year end

·         Delayed transfers of care were significantly lower

·         The use of technology enabled care continued to increase

·         Ask Sara, a virtual OT service, was due to be launched imminently

·         Pressures remain:

o   Winter pressures – although the Welsh Government provides some funding, this will end at the end of March but the associated pressures may continue into the new financial year

o   Domiciliary care – the service continues to try to reshape demand

o   Residential Care – there had been a spike in residential care which has continued into January.  Although fewer residents are being admitted, numbers remain high

·         Members raised concerns regarding end of life care and asked that a representative of the Health Authority be invited to a future meeting to discuss the issue

·         The recent flooding had caused concerns for both service users and carers.  There had been significant challenges during the past week and the communities had also been very responsive in assisting where necessary.  The Committee asked that a letter of thanks be sent.

·         Once the initial crisis has been dealt with, Members asked if there was sufficient capacity to support affected residents in the coming weeks

·         Commissioning – there had been an increase in individual costs which were concerning and a risk.  The Committee asked how this was being dealt with.  The Head of Commissioning informed the meeting that a fair cost of care exercise had been completed in conjunction with care homes and an agreement had been reached regarding the cost of care.  As Members were aware, no uplift had been provided for 2019/20 but this agreement will be renegotiated for the forthcoming financial year.  Care homes had had to absorb the costs of increases in inflation and the living wage.

·         Supported employment – the report indicated that the Disability Team was under stress through supporting employment.  Reviews for supporting employment had been prioritized leading to pressures elsewhere.  However, the review had been completed and supported living provision was working in a holistic way in each area.

·         Agency staff – there had been an increase in agency workers although the number remained lower than it had been.  Winter pressures funding had enabled a team to be created in hospital settings.  This will finish at the end of March when the funding ceases.

·         Concern was raised regarding the number of residents being discharged from hospital into residential care.  Whilst this had had a positive impact on the number of delayed transfers of care, it was thought that this may not be the most appropriate model of care.  Discharging to a residential home can be a good step-down model if it is supported in the right way.  If a client needs domiciliary care for the first time, there are challenges regarding availability, but an existing client should have arrangements in place.  Step-down beds should only be used for  ...  view the full minutes text for item 6a

6b

Children's Services Performance Report - December 2019 pdf icon PDF 3 MB

To consider the December 2019 Performance Report for Children’s Services.

Minutes:

Documents:

·         Children’s Services Performance report as at 31 December 2019

 

Discussion:

·         WCCIS has been a cause for concern as staff have not been able to access the necessary systems.  This has been escalated and is being dealt with.

·         The adverse weather has also presented challenges

·         Seven Child Protection Enquiries had not been completed in time – this represented three families and it had not been possible to conclude enquiries without legal advice

·         No assessments were outstanding as at 24 February 2020

·         The number of starters and leavers did not include agency staff.  Officers were asked if the reasons for leaving were available.  There had been a spike in starters in July when the new staffing structure had been introduced.  A new recruitment campaign is being launched in the north of the county.  All leavers have an exit interview and the Corporate Director is provided with a monthly report

·         In November there were 42 agency staff in place.  This has reduced to 34.  A supplementary payment will be offered to recruit to some hard to fill posts.  This follows on from scrutiny work relating to pay comparisons.

·         A new interactive report was available regarding children’s placements.  This would be demonstrated to the working Group.  The number of out of county placements had reduced to 58 in December from 82.

·         There were 237 Children Looked After

·         The Committee asked where fostering and adoption statistics were reported.  Corporate Parenting Group received details of fostering arrangements, but adoption was considered on a regional basis.  The Portfolio Holder had requested more information and this report will be shared with the Committee.

 

Outcomes:

·         New interactive reporting would be presented to the Children’s Services Working Group

7.

Finance pdf icon PDF 814 KB

To review the Financial Overview and Forecast Report as at January 2020, with particular reference to the sections relating to Adult Services and Children’s Services.

Minutes:

Documents:

·         Financial Overview and Forecast as at 31 January 2020

 

Discussion:

·         The costs of storm Dennis may impact upon the social care budget.

·         Members were of the opinion that such events should be met from reserves

 

Outcomes:

·         The report was noted

8.

Integrated Emotional health and Wellbeing and South Support Update pdf icon PDF 294 KB

To consider the report of the Portfolio Holder, County Councillor R Powell.

Minutes:

Documents:

·         Report of the Portfolio Holder for Young People and Culture

 

Discussion:

·         The Portfolio Holder provided an update on the Integrated and Emotional Health and Wellbeing and Youth Support Workstream that sits under the Start Well Board

·         The aim is to avoid escalation and crises

·         This programme covers the age group 0 to 25 years

·         Members questioned whether recruitment was a risk to the project – a permanent Psychologist has been appointed jointly with the Health Board.  Funding has allowed resources to be increased by increasing the hours of existing staff.

·         Integrated working

 

Outcomes:

·         The report was noted

9.

Children First Project pdf icon PDF 218 KB

To consider the report of the Portfolio Holder, County Councillor R Powell.

 

Minutes:

Documents:

·         Report of the Portfolio Holder for Young People and Culture

 

Discussion:

·         Newtown Together is a Children First Project designed to improve opportunities and reduce deprivation and need

·         This project mirrors the Flying Start programme

·         The project will be replicated in Welshpool but will be shaped by the community

·         Evaluation is being built in

·         Case studies and videos are being prepared which will be available to Members in due course

·         Members asked how involved GPs were - GPs tend to refer to more specialised agencies.  In this instance, the residents need to accept any support.

·         The project provides another strand of community based early intervention and prevention

·         The project is funded to the end of 2021.  Other funding has been attracted.  As the work has stemmed from the community, it is hoped that this will be continued beyond 2021.

 

Outcomes:

·         The report was noted

10.

Quality Assurance

To receive a presentation on Quality Assurance.

Minutes:

This item was withdrawn.

11.

Mid Wales Growth Deal - Joint Scrutiny Working Group

To appoint one Member of the Health and Care Committee to sit on the Mid Wales Growth Deal Joint Scrutiny Working Group.

Minutes:

RESOLVED that County Councillor J Charlton be appointed as the Committee’s representative on the Mid Wales Growth Deal Joint Working Group.

12.

Working Groups - summary reports

12a

Adult Services Working Group pdf icon PDF 153 KB

To note the summary report of the Adult Services Working Group.

Minutes:

Documents:

·         Scrutiny summary report – Adult Services Working Group

 

Outcomes:

·         The report was noted

 

 

12b

Children's Services Working Group pdf icon PDF 197 KB

To receive the summary report of the Children’s Services Working Group.

Minutes:

Documents:

·         Scrutiny summary report – Children’s Services Working Group

 

Outcomes:

·         The report was noted

 

13.

Work Programme pdf icon PDF 335 KB

To note the scrutiny forward work programme.

Minutes:

Documents:

·         Forward work programme 2020

 

Outcomes:

·         The following items to be added to the work programme

o   End of Life Care – representative of the Health Board to be invited to attend

o   Capital investment for north Powys community hospitals – a representative of the Health Board to be invited to attend

o   Adoption and Fostering recording

o   Dementia Friendly authority - update