Contact: Lisa Richards
To receive apologies for absence.
Declarations of Interest
To receive declarations of interest from Members.
There were no declarations of interest.
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.)
There were no disclosures of party whips.
To authorise the Chair to sign the minutes of the last meetings held on 26 and 27 May 2021 as correct records.
The Chair was authorised to sign the minutes of the last meetings held on 26 and 27 May 2021 as correct records.
To receive a briefing on the North Powys Programme.
· North Powys Wellbeing Programme – presentation slides
Carly Skitt, Assistant Programme Director, gave the Committee a presentation on the Programme which will deliver a model of integrated care across north Powys initially and across all of Powys in the longer term.
· A key driver for the development in the north of the County was that planned care services were moving further away from the area and an aspiration to deliver services closer to home.
· Digital opportunities are increasing and have been further developed due to the pandemic
· The outcomes of the programme are to promote health and wellbeing, prevention and promote independence
· The Programme will also improve integration
· Public sector assets will be developed across partners
· The Programme will also support the carbon reduction agenda
· Transformation funding was obtained and the project was commenced in 2019 to develop an integrated model of care
· The pandemic saw the model of care be put on hold
· The Programme Business Case will be submitted to the Welsh Government within the next few weeks
· The multi agency campus vision is continuing to develop
· A community first approach is being taken
· There will be further public engagement over te summer and autumn
· A Community Development Officer is being recruited to drive this forward
· Work is ongoing with schools to develop how the hub can be used
· The focus will also be on Start Well
· The project has continued during the pandemic, but operational teams have necessarily been focussed on pandemic work
· Three priorities have been identified in the short term
· Self Care – supporting those with long term conditions and enabling care to be provided closer to home
· Ambulatory Care – care closest to home for those with the highest clinical need, ophthalmology, respiratory services etc
· Frailty – integrated community model and join up services to focus on prevention
Demand capacity and financial modelling has been commissioned
· The Business Case will be submitted to the Welsh Government during Q3 although there are some challenges with capacity at an operational level to support this work
· The Committee questioned how the Council had been involved with design of the programme and with the governance and assurance required. The Portfolio Holder confirmed that there had been partnership working from the start. The Programme had been developed following a needs assessment. Both partners are committed to the person-centred approach. This ties in with Powys’ corporate ambitions including carbon reduction. The third sector have also been heavily involved.
· The Head of Service informed the Committee that the Authority had been integral in developing the Health and Care Strategy and has been an active partner in driving the new model of care. As work progresses, clinical and professional groups are working closely together. There is further work to undertake with Education and Housing. Demand has changed during the pandemic and there have been some delays too.
· The Portfolio Holder highlighted the strengths that had been shown to work in communities during the pandemic and she wanted to maintain that ... view the full minutes text for item 5.
To consider the report of the Portfolio Holder for Adult Services and Welsh Language.
· Scrutiny covering report
· Transforming Prevention Services: Roll-out and mainstreaming of Home Support Services across Powys
· Home Support is a very effective early intervention and prevention service
· In addition to benefitting individuals, it also assists Health and Ambulance Services etc
· The service provides informal support at home and a 24/7 emergency response
· There are plans to further develop the service in the Ystradgynlais area using the Extra Care Housing provision to provide outreach support
· Formal governance is required, with the Cabinet and Regional Partnership Board being asked for strategic support and funds to develop a business case to roll the service out across the County
· The Health and Social Care Change Manager (Live Well) advised Members that there was evidence to show the benefit both to the individual and as a return on investment. The service currently runs in Rhayader and East Radnorshire.
· The service has been found to promote community cohesion
· The pandemic has seen a willingness for people to volunteer but Members were cautious that this would continue once furlough schemes had ended and business returned to normal. However, the Portfolio Holder was of the opinion that greater engagement with communities through leadership by the local Councillor would help. The case could also be made to those who have not yet volunteered, for example new home workers to may feel more isolated, or younger people looking to gain experience. This will help build community resilience. A Volunteers Strategy has been developed and current services are being repurposed and reconfigured.
· It was recognised that volunteers worked well in smaller, rural communities but the Committee questioned whether this would work as effectively in urban areas where community support was not as prevalent. There was a need to understand each locality thoroughly and to take an intelligence led approach.
· There is an integrated steering group comprising Health, Housing, PAVO and the Authority. This needs to be further strengthened and more detailed evidence provided, particularly around cost avoidance for other partners. The Terms of Reference of the steering group have been rewritten. Members were keen that other partners who may benefit from decreased demand for their services, also contribute to the Home Support Service.
· The report was supported
To consider the Market Position Statement and Powys Pledge.
· Scrutiny covering report
· Market Position Statement
· Powys Pledge
· The Head of Commissioning reminded the Committee of the fragility of the domiciliary care market and of the issues experienced by the Authority five or six years previously
· The situation had improved dramatically over the preceding 18 months with the numbers of clients waiting for a package of care falling. The average time a client waited for a package had also fallen from 40-60 days to less than a week
· An additional 1000 hours per week were being provided compared to the previous year, demonstrating the commitment to supporting people at home
· The Market Position Statement is now a live document online and will help service providers
· The Powys Pledge has been considered by scrutiny previously. Its purpose is to identify the criteria a provider would need to meet. The Pledge sets a standard to be achieved - this year a Bronze Pledge is the goal, increasing to Silver next year. This will help to ensure the long-term sustainability of the market.
· The Chair asked where the service envisaged the medium to long term risks would be and what factors had led to a decrease in waiting lists. The Portfolio Holder noted there had been a lot of focussed work by officers including geographical challenges and the rural nature of the County. The Community Catalyst has also helped solve many issues. Technology Enabled Care (TEC) had also had a role to play and care packages had been ‘right sized’ and tended to be smaller
· Active, ongoing projects include quality assurance for micro enterprises, prevention though use of TEC etc and increasing capacity
· The Plan on a Page has been reviewed considering lessons learned during the pandemic
· The Health and Care Academy will develop bespoke training for those new to caring roles and for those wishing to return to work
· The Cabinet have agreed increased funding for domiciliary care and a means by which the terms and conditions of care staff are improved
· Officers were asked how the closure of the day centres had affected the service. There were still some areas of the County where it was more difficult to provide care and currently there is additional pressure from hospitals in Herefordshire. Demand has increased across Wales. It was also noted that some staff who had previously been employed in the tourism sector were now employed in the care sector. Day Centre staff have been redeployed to support clients in their own homes. It may now be possible to open day centres for shorter breaks, but staff are redeployed to other roles and are not available for day centres.
· Support from the Authority for care homes had been welcomed during the pandemic
· Members noted that residents needed clarity around the process for Continuing Health Care (CHC). CHC should be provided where a person has a primary health need which is regular and consistent. A multi-disciplinary team, using a decision support tool, provides a recommendation for either CHC or social care. ... view the full minutes text for item 7.
To note the scrutiny forward work programme.
· Forward work programme
· The work programme was noted