Agenda, decisions and minutes

To receive any Declarations and advise Members accordingly.

None.

None.

To confirm as a correct record the minutes of the meeting held on 31 January 2019.

That subject to the amendment, the minutes be approved as a correct record and signed by the Chair.

The minutes of the meeting on 31 January 2019 were received.

Matters Arising

Minute number 51: North Wales Community Health Council - Councillor Bateman clarified that her question had been about waiting times after triage at Accident & Emergency departments and whether patients were classified according to their condition whilst waiting after triage.

RESOLVED:

That subject to the amendment, the minutes be approved as a correct record and signed by the Chair.

That Members are aware of the process of Delayed Transfers of Care and how it is monitored and managed each month.

The Chief Officer (Social Services) introduced a report on the role and function of the Delayed Transfer of Care (DTOC) process, the structure of hospital-based social work and its collaboration with Health colleagues.  A DTOC occurred when a hospital patient was fit for discharge to another setting beyond the date agreed by the lead clinician.

The report set out a range of activities to minimise delays to hospital discharge which was a key priority for the service.  Whilst there had been a slight increase in DTOC numbers since last year for people aged over 75, Flintshire’s performance was good across North Wales councils.  Members were told that a breakdown of DTOC categories was available upon request.

The Senior Manager, Integrated Services, Lead Adults provided details on the monthly census involving the collection of data from the three local acute hospitals which would include data from the Countess of Chester Hospital from April.  The slight increase in DTOC figures for this year was due to the rising number of referrals and complex issues involved.

Members were introduced to the Service Manager - First Contact & Locality Services (Janet Bellis) who explained that the majority of people now entering hospital were elderly with multiple health conditions and a diminishing family support network.  Social work teams across the three hospitals were rotated according to areas of high demand, however all three hospitals were often on red alert.  The hospital discharge protocol involved a multi-agency approach to meet people’s expectations to remain at home for as long as possible.

The Chair referred to the DTOC codes appended to the report and requested a breakdown of the reasons for the delayed transfers of the 44 individuals in the current year.  Officers explained that amongst the many DTOC codes, most applied to those in category 2 ‘community care arrangements’, for example housing or home care related issues, residential care placement arrangements etc.  The Chair remarked that the Committee had not received an update on Disability Facilities Grant adaptations for some time.  Officers said that ‘step down’ placements were provided where a delayed transfer had arisen from a person awaiting such an adaptation.

Councillor Mackie praised the officers’ knowledge on the matter.  He said that figures reported by Stats Wales appeared to indicate that most DTOCs involved issues outside the Council’s control and that the proactive approach taken by the Council should be highlighted.  He suggested a future agenda item on activities which helped to keep people out of hospital.

In response to concerns from Councillor McGuill about the challenges of discharging via the Intermediate Care Fund, officers explained the role of the hospital social work teams to facilitate hospital discharge until the person was safe elsewhere.  Where further care was needed, the person was supported by a community-based social worker.  Hospital social worker teams were currently only available during office hours, in line with other social care professionals, although an out-of-hours service was provided by Discharge Liaison teams.

Councillor Hinds referred to the difficulty in engaging  ...  view the full minutes text for item 58.

That the Quarter 3 Council Plan monitoring report 2018/19 be noted.

The Chief Officer (Social Services) introduced a report providing a summary of the position at Quarter 3 of 2018/19 for the Council Plan priority ‘Supportive Council’ which was relevant to the Committee.

This was a positive report reflecting that 92% of activities were making good progress and 85% likely to achieve the desired outcome.  Risks were being successfully managed with the majority assessed as moderate or minor.  On the percentage of looked after children with a timely health assessment, despite a range of actions, the challenges were continuing and would be raised again at a forthcoming meeting with Health partners.

On the same matter, the Senior Manager, Children and Workforce spoke about the importance of work undertaken by Julie Sproston, the Looked After Children Nurse, whose recent presentation on her role had been well received by the Children’s Services Forum.

The only major risk was on meeting demand for residential and nursing home care bed availability where officers were exploring innovative solutions including co-operative models, however the challenges of recruitment and retention in care provision remained a longer-term problem.

The Senior Manager, Safeguarding and Commissioning provided information on the risk on adult safeguarding referrals which had been upgraded to green following a restructure of the service and review by Internal Audit.  She advised that the Quarter 4 update would reflect the improvements achieved which had been well received during a recent visit by the Care Inspectorate Wales.

Councillor Mackie queried the accuracy of ‘period actual’ and ‘year to date actual’ data on key performance indicators.  The Senior Manager agreed to refer this to the Performance team, adding that some may have been affected by the main activities taking place during the last quarter.

As requested by Councillor McGuill, the Senior Manager, Children and Workforce provided an overview of the joint agency project with North Wales Police which aimed to deliver an Adverse Childhood Experiences informed approach to community policing.  Since completion of the training, there had been a slight reduction in these CID referrals to Social Services.  The Senior Manager agreed to circulate a link to a video clip where Police officers described the impact of the training.

RESOLVED:

That the Quarter 3 Council Plan monitoring report 2018/19 be noted.

To receive a verbal report from Members of the Committee.

That the update be noted.

Councillors White and Dunbobbin gave positive feedback on a visit to the specialist day service at the Old Brewery in Shotton where they had been particularly impressed by the dedication of the staff.  They took the opportunity to highlight the need for volunteers.

Councillor Bateman agreed to accompany Councillor McGuill on her forthcoming visit to Llys Gwenffrwd whilst the Chair planned to visit Marleyfield and the daycare centre.

RESOLVED:

That the update be noted.

(a)       That the Forward Work Programme be updated accordingly; and

(b)       That the Facilitator, in consultation with the Chair of the Committee, be authorised to vary the Forward Work Programme between meetings, as the need arises.

In considering the Forward Work Programme, the Facilitator advised that a report on keeping people out of hospital and at home for longer would be scheduled for October, as requested earlier in the meeting.

The Senior Manager, Children and Workforce asked that an item on young carers be scheduled for October with Barnardo’s in attendance.

Following earlier discussion, the Chair requested that the Committee be updated with current performance on the social care element of Disabled Facilities Grants.  The Facilitator advised that the Community & Enterprise Overview & Scrutiny Committee was kept updated as part of its remit and that a joint meeting could be arranged if required.  The Chief Officer suggested that an update be included in the Quarter 4 performance report to enable the Committee to decide whether a joint meeting was needed.  This was agreed by Members.

Officers reported on the closure of the Windmill in Buckley at the end of April, which provided daytime support for older people.  Social workers were engaging with the affected individuals and their families to explore alternative options and keep friendships together where possible.

RESOLVED:

(a)       That the Forward Work Programme be updated accordingly; and

(b)       That the Facilitator, in consultation with the Chair of the Committee, be authorised to vary the Forward Work Programme between meetings, as the need arises.

There were no members of the press or public in attendance.