Agenda, decisions and minutes

Councillor Andy Dunbobbin declared a personal interest in agenda item 5 Integrated Family Support Service as he was a Kinship Carer.

Councillor Mike Lowe also declared a personal interest in agenda item 5 Integrated Family Support Service as he was a Carer. 

Councillors Hilary McGuill and Dave Mackie declared personal interests as members of the Community Health Council.   

To confirm as a correct record the minutes of the meeting held on 25^th November 2013.

That the minutes be approved as a correct record and signed by the Chairman. 

The minutes of the meeting of the Committee held on 25 November 2013 had been circulated to Members with the agenda. 

RESOLVED:

That the minutes be approved as a correct record and signed by the Chairman. 

(a)       That the continued success in managing and developing regional project/service collaboration be noted;

(b)       That the content of the Statement of Intent be supported;

(c)        That a quarterly update from the Social Services and Health Programme Board and other relevant boards be submitted to the Committee.  

The Director of Community Services introduced a report to receive a progress report on projects and services running collaboratively across North Wales including the development of a Statement of Intent on Integrated Care for Older People with Complex Needs. 

He detailed the background to the report and explained that there were a significant amount of social care projects and services that were well established and continued to run effectively across the North Wales region.  A draft of the Statement of Intent was required by the end of January 2014 and it would then be commented upon by Welsh Government (WG); it would not be formally agreed until the end of March 2014.  The Director of Community Services provided detail on the established collaborations which included North Wales Commissioning Hub, Telecare/Telehealth & Assistive Technology, Emergency Duty Team, North Wales Adoption Service and Mental Health Measure/Partnership.  Details of new developments, such as Commissioning New Services and Safeguarding Systems and Workforce, which had recently secured WG funding to develop the collaborations were also reported.  Section three of the report provided details of the governance arrangements and management structures in place.  A Strategic Partnership Board with Betsi Cadwaladr University Health Board (BCUHB) had been established and the Board was chaired by the Leader of the Council and membership included the Chief Executive and Cabinet Member for Social Services.   

The Statement of Intent provided a single regional statement on Integrated Care for Older People with Complex Needs between the North Wales Local Authorities and BCUHB.  It was designed to be responsive to local need and historical service developments whilst developing an ambitious agenda to develop new innovative services.  The Director of Community Services explained that it was a lengthy document which was not yet complete and a draft version had been attached as appendix one to the report.  There was a need for a strong integrated approach to services for older people and the document highlighted current arrangements and future intent and included sections on Leadership to drive the vision, Commissioning, Resources Management/Pooled Budgets and Managerial/Service Integration.  Partnership working within North Wales was further supported by the Social Services and Health Programme Board and the Director of Community Services provided details of the membership of the Board. 

Flintshire County Council was the lead on the Community Equipment Service.  A significant amount of progress had been made on the development of locality teams and the co-location of one of the teams had taken place in December 2013.  The Director of Community Services explained that WASPI on page 24 stood for Welsh Accord Sharing of Personal Information and was a data sharing protocol which supported joint working.  It was reported that there were a number of excellent examples of citizen centred/co-produced services in Flintshire and service delivery integration and service provision were also reported.  Flintshire was the host organisation for the Regional Programme Manager and was currently developing a local Single Point of Access (SPOA) project team to take the development forward locally. 

Councillor Hilary McGuill felt that  ...  view the full minutes text for item 44.

That the report be noted.                  

The Head of Children’s Services introduced the report to update the Committee with the progress of the Integrated Family Support Service since the Service became live in Flintshire.

She detailed the background to the service, explaining that a bid from Wrexham County Borough Council (WCBC) to become a pioneer site had been approved and funding of £650,000 had been provided at the start of the project.  A joint team had been established with WCBC and Flintshire County Council so some of the infrastructure was already in place.  The IFSS grant for North Wales for 2013/14 was £850,000 and it was projected that the full spend would occur against the grant as local authorities already up and running with IFSS were providing additional support to the new authorities setting up their IFSS teams.  It had originally been planned that the service would be rolled out to parents with mental health problems and where drug use was an issue but this had been scaled back. 

In response to a question from Councillor Stella Jones, the Head of Children’s Services said that if families were not referred to the IFSS cohort, then they would be dealt with by the Children’s Services Teams. 

Councillor Hilary McGuill asked about referrals for mental health and substance and alcohol misuse problems and also requested further details about the 13 re-referrals which had been accepted by the IFSS team.  The Consultant Social Worker/Operational Manager explained that the problems experienced by the families that the team worked with were complex.  Following referrals from social workers to the IFSS, assessments would be undertaken and this would highlight any barriers that would prevent the action that the social worker was requesting being undertaken.  If barriers were highlighted, then the necessary work to overcome these would be carried out to give the family the best chance to keep the children safe and once this had been undertaken, it could result in a re-referral to the IFSS.  The Consultant Social Worker/Operational Manager explained that the IFSS worked closely with the social workers and that significant assessments for the children were undertaken to ensure that if the need arose, the family would be referred to the IFSS.  The Head of Children’s Services advised that even when families were referred to the IFSS, their case could still remain open with the mainstream Children’s Services Team.  The Consultant Social Worker/Operational Manager said that if it was not possible for the adults in the family to make the necessary changes suggested, then the IFSS Team provided possibilities for further intervention.  Following a question from Councillor McGuill about the trigger points for identifying areas of concern, the Consultant Social Worker/Operational Manager said that they would be identified at phase one of an assessment whether the family was a safe enough place for the child to be.  Councillor Dave Mackie said that the information provided by the Consultant Social Worker/Operational Manager should be included in the report. 

The Chair referred to paragraph 3.18 on the funding for the IFSS  ...  view the full minutes text for item 45.

(a)       That the report be noted;

(b)       That a further update report be submitted to the Committee in six months time; and

(c)        That the GP locality lead be invited to attend a future meeting of the Committee.                          

The Intake and Reablement Service Manager introduced the report to provide Members with an update of the progress of Enhanced Care at Home in Flintshire. 

She detailed the background to the report, explaining that the scheme had been launched in North West Flintshire in September 2013 and that some areas had been learned from a scheme which had been undertaken in Denbighshire.  A number of patients had been admitted to the scheme, mostly from General Practitioners (GPs) in Flint, and work was still ongoing with GPs in Holywell.  The service was now fully staffed with an Advanced Nurse Practitioner (ANP), a number of band five nurses, social workers and administration support in post. 

The Intake and Reablement Service Manager explained that the referral process to  enhanced care which was either a ‘step up’ from home or ‘step down’ from hospital.  She detailed the process involved and said that most people were on the scheme for a week or two and to date, 26 patients had been admitted to Enhanced Care.  During their stay in Enhanced Care an assessment was carried out by the ANP and a decision was reached on whether the patient would be discharged to reablement or to their home.  The total budget for Flintshire was just under £1m and this had been toploaded in the North West Flintshire budget to support a vehicle to transport equipment to support people in their own homes; the budget for Holywell was £385,447.  The Intake and Reablement Service Manager detailed some of the feedback that had been received from families who had been admitted to Enhanced Care.        

            In response to a question from Councillor Hilary McGuill about whether the service was working, the Intake and Reablement Service Manager said that she felt it had been successful so far but added that she would welcome Holywell GPs being more engaged with the service.  She added that the lead GP had been visiting colleagues and it was hoped that this and the positive feedback that had been received from those admitted to Enhanced Care would encourage them to take part.  The issue had also been raised at the Strategic Partnership Board meeting attended by the Director of Community Services. 

            Councillor McGuill sought clarification about when weekend assessments would commence and also asked what happened to the patients after the end of the two week period.  The Intake and Reablement Service Manager responded that an assessment was carried out and as a result of this, some patients may require reablement and then additional assessments would identify whether discharge to home was appropriate or whether the patient required further reablement or admission to hospital.  She felt that weekend assessments would be considered when an additional two ANPs were in post. 

            Councillor Stella Jones asked for further information on the financial costs and queried whether those not able to pay for the Enhanced Care would be admitted to hospital.  She felt that Betsi Cadwaladr University Health Board (BCUHB) were under increased pressure to empty  ...  view the full minutes text for item 46.

(a)       That the report be noted;

(b)       That the Forward Work Programme be amended to take account of the suggested changes and amendments. 

The Environment and Social Care Overview & Scrutiny Facilitator introduced the report to consider the Forward Work Programme for the Committee. 

The Facilitator reminded Members of the Joint Social & Health Care and Housing Overview and Scrutiny Budget meeting which was scheduled to take place on Tuesday, 28^th January 2014 and explained that the start time of the meeting had been changed from 9.30am to 9.15am. 

Details were also provided by the Facilitator of the items scheduled for consideration at the Joint meeting of this Committee and Housing Overview & Scrutiny Committee on 6 February 2014 at Llys Jasmine in Mold.  It was suggested that the start time of the meeting be moved to 1pm to allow a short tour of the facility to take place. 

For the meeting on 13 February 2014, the Facilitator advised that the CSSIW Inspection Report would not be submitted as the Inspection was not taking place until week commencing 13th January 2014 and the report would therefore not be ready.  Jackie James would be attending the meeting to provide an update on Public Health and a discussion on Rota Visits would also be taking place.  Councillor Hilary McGuill asked for an updated list of Visits. 

The Facilitator provided details of the items scheduled for consideration at the 20 March 2014 meeting and suggested that a Task Group be established to look at the Annual Council Reporting Framework before its consideration at that meeting.  She added that the Annual Fostering Inspection report may need to be moved to a later meeting if it was not ready for submission to the meeting on 20 March 2014. 

It had been suggested that reports on the CSSIW Action Plan Update and the Emergency Duty Team Update be submitted to the 12 June 2014 meeting of the Committee.  The Facilitator also advised that reports on Foster Care and Family Placement Team and an Update on the Single Point of Access would be submitted to the June or July 2014 meeting of the Committee.  

RESOLVED:

(a)       That the report be noted;

(b)       That the Forward Work Programme be amended to take account of the suggested changes and amendments. 

There was one member of the press and no members of the public in attendance.