Agenda, decisions and minutes

Purpose: To receive any Declarations and advise Members accordingly.

Personal interest declared by Councillor Ian Smith.

Councillor Ian Smith declared a personal interest on Agenda Item 5 ‘Adult Safeguarding Report’ as his stepson was living in an assisted living placement funded by the Council.

Purpose: To confirm as a correct record the minutes of the meeting held on 17 December 2015.

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

The minutes of the meeting held on 17 December 2015 had been circulated with the agenda.

RESOLVED:

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

(a)       That the CSSIW’s evaluation of performance for 2014/15 and areas for improvement be noted;

(b)       That the Authority’s response to areas that have been identified for improvement be noted; and

(c)       That mental health services be included as part of the Forward Work Programme.

Mr. Rob Gifford presented the Care & Social Services Inspectorate Wales (CSSIW) annual report on the evaluation of performance of Flintshire Social Services for 2014/15.  The report incorporated paragraph numbering as a standard feature as requested previously by the Committee.  The three key areas highlighted for review by CSSIW over the next year were:

1.    Arrangements for Adult Safeguarding.

2.    Community mental health service arrangements.

3.    Access, assessment and care management arrangements in Children’s Services.

On the latter, Mr. Gifford advised that he was meeting regularly with the Senior Manager for Children’s and Workforce Services to discuss progress in implementing the Council’s action plan in response to the CSSIW inspection in 2015.  An update on this was scheduled for the next meeting of the Committee.

Mr. Gifford explained that whilst the three national reviews mentioned in the CSSIW report would not directly affect the Council, the recommendations made would need to be noted.

During an overview of adult services, Mr. Gifford described performance as very positive, particularly in relation to the Council’s key priorities such as reablement services in responding to the significant increase in referrals.  Good progress was also noted in the provision of homecare support and general support to enable better independence in communities.  The effective transfer of care arrangements was highlighted as one of the best in Wales, however numbers were increasing due to the lack of nursing home care provision which was a growing problem across the country.  Positive outcomes were recognised from the Council’s range of preventative service initiatives such as the night-time response service, continued growth of extra care provision and improved responses to minor adaptations in communities.  As an improvement from last year, the increased number of carers receiving an assessment of their needs was recognised as the highest in Wales.

The report also identified some areas for improvement including some where work was already underway following the recent management restructure.  Whilst the Council’s focus on adult safeguarding arrangements was noted, further strengthening was required to speed up responses and ensure that the voice of the service user was heard.  Delays in the completion of major adaptations for Disabled Facilities Grants (DFG) was also identified, in recognition of the impact on the small number of individuals involved.  Other issues related to the implementation of Single Point of Access (SPoA) and the need for strategic planning with the Health Board to explore more sustainable opportunities and support locality working.

The Chair stated that many of the issues identified in the inspection of Children’s Services had previously been raised by the Committee and were being monitored through regular updates.

The Chief Officer thanked Mr. Gifford for his report and in particular for endorsement of the Council’s approach to homecare and reablement.  He welcomed the recognition of sustained performance on the delayed transfer of care which was a priority for the Deputy Health Minister and said that work would continue on direct payments and the progression model to support independence of people with learning disabilities.  He spoke  ...  view the full minutes text for item 55.

(a)       That the contents of the report be noted;

(b)       That the increase in applications under the Deprivation of Liberty Safeguards be particularly noted; and

(c)       That the concerns of the Committee on the financial impact of future services be noted.

The Adult Safeguarding Manager presented the annual adult safeguarding report for April 2014 to March 2015 in compliance with the Welsh Government statutory document ‘In Safe Hands’.  He spoke about the continued increases in adult safeguarding referrals on which all agencies worked together ‘on the ‘identification, investigation, treatment and prevention of abuse of vulnerable adults’.  Information was shared on the process of evaluating referrals and work with Wrexham County Borough Council on local implementation of thresholds.  More work would need to be carried out on the definition of who should be protected under the adult safeguarding procedures to be clarified under guidance for the new legislation.

Of the 416 referrals received during the period, 173 had met the threshold for progression, 199 failed to meet the threshold and 44 had not been considered appropriate.  The figures within the report indicated a breakdown of all the referral sources along with the status of those which had met the threshold.  As a change from the usual trend, more referrals had related to women under the age of 65 than over.  It was noted that different types of abuse could be related and that each situation was significant to that person and their families.

An update was also provided on the Deprivation of Liberty Safeguards (DoLS) introduced to give legal protection for vulnerable individuals in care homes who lacked the mental capacity to make their own decisions.  The scope of DoLS had broadened following a court ruling in 2014, and this was reflected in the significant increase in referrals for assessment.

Councillor Hilary McGuill asked whether this increase included residents in sheltered accommodation and sought details of the process for dealing with referrals not meeting the threshold.  The Adult Safeguarding Manager advised that the DoLS covered individuals in care homes and hospitals only and that those authorities were responsible for identifying individuals in need of assessment.  He explained that when referrals were not taken forward, the team worked with social workers, police, etc to ensure the safety of the situation and to ease the concerns of the individual.  The individual was advised of the status of their case by telephone and a record of the discussion kept electronically.

When asked by Councillor McGuill for clarity on the definition of a vulnerable adult, she was advised of the definition in Wales of a person over 18 in community care services who was unable to protect themselves from abuse or harm.  The proposed widening of the term ‘vulnerable adult’ to ‘adult at risk’ had an extended remit and could include other groups in need of care and support such as young people or individuals who were homeless.

The Chair drew attention to the financial pressures on the Council arising from DoLS referrals, and asked whether additional funding would be forthcoming or shared from the health sector to support the process.  The Chief Officer stated that most of the financial burden was on councils with no additional funding identified from any source.  The additional funding allocated  ...  view the full minutes text for item 56.

(a)       That the Committee welcome further developments on extra care facilities in Flintshire; and

(b)       That an update on further progress be shared with the Committee.

The Senior Manager: Integrated Services, Lead Adults presented an update on the development of two new Extra Care facilities in Flint and Holywell following the successful delivery of schemes in Shotton and Mold.  She welcomed recognition by the Care & Social Services Inspectorate Wales of the model used by the Council and said that the new developments would help to meet anticipated demand, as set out in the Council’s Improvement Plan and Housing Strategy.

An update was given on the design of the project at Flint which would also incorporate ground floor accommodation for people with Dementia.  Work was due to start on site in February 2016 and the scheme was expected to be opened in Autumn 2017.  With regard to the scheme in Holywell, the refusal of planning consent for the original site meant that other available sites were being explored in the locality, prior to seeking planning approval and consultation with Holywell Town Council.  Further updates would be shared with the Committee when available.

Councillor Mike Reece asked about the potential for a scheme in other areas, and was advised that Wales & West were exploring opportunities in the Holywell locality.

Councillor David Healey welcomed the new developments to increase housing options for the ageing population.  In response to a query, the Senior Manager explained that the developments would be wholly owned by the registered social landlords unless sold to individuals.

Councillor Hilary McGuill referred to her list of suggested requirements for extra care provision previously shared with officers and asked whether this had been taken into consideration for the two new developments.  The Senior Manager said that some of the issues raised had been taken forward as part of these developments, along with some of the lessons learned from the first two extra care schemes.

Councillor Dave Mackie passed on the positive comments from two service users who had been very supportive of the schemes.

In response to a question from Councillor Ian Smith on the Flint scheme, it was stated that parking provision had been carefully considered and had been considered sufficient by the Planning Committee.

It was pointed out by the Chair that the Flint scheme was near to a large retail park with generous parking provision and that most residents of extra care schemes did not drive, all of which had been taken into consideration as part of the planning process.

Councillor Nancy Matthews reminded Members of insufficient parking provision for sheltered accommodation.  The Senior Manager said that the average age of extra care residents and learning from other extra care schemes had helped to inform plans for the design of the new schemes with parking provision incorporating a buggy store.

RESOLVED:

(a)       That the Committee welcome further developments on extra care facilities in Flintshire; and

(b)       That an update on further progress be shared with the Committee.

Purpose: To receive a verbal report from Members of the Committee.

That the information be noted.

No rota visits had been undertaken since last reported.

RESOLVED:

That the information be noted.

That the Forward Work Programme be updated accordingly.

The Facilitator introduced a report to enable the Committee to consider the Forward Work Programme.  The following was noted and agreed:

·         A reminder of the cancellation of the budget meeting of the Committee scheduled for 25 January 2016.

·         The two Children’s Services items scheduled for the next meeting on 3 March 2016 to be considered as a joint report.

·         A joint meeting with the Education & Youth Overview & Scrutiny Committee on 24 March 2016 to consider items on corporate parenting and the education of looked after children.

·         The Annual Council Reporting Framework item scheduled for 14 April 2016 to be deferred to a later date.

·         The items on outcomes of the residential care review and mental health issues to be included on the Forward Work Programme.  Councillor Jones suggested that the latter item include a presentation by Double Click.

It was also noted that representatives of Betsi Cadwaladr University Health Board (BCUHB) had been invited to attend a special meeting of the Committee on 9 June 2016.

Councillor Cindy Hinds highlighted the need to address the ongoing problem of bed-blocking in hospitals with BCUHB and also with the Wales Ambulance Trust.  The Chair said that this linked with capacity issues identified as part of the review of residential care homes.  She went on to refer to a change in criteria for emergency service calls and the lack of consultants in hospital Accident & Emergency departments which had been recognised as a widespread problem.  Councillor Mike Reece raised a further health issue on the challenges experienced by pensioners in seeking appointments for ear syringing.

The Committee supported the suggestion made by the Facilitator that the Wales Ambulance Trust be invited to the meeting, along with BCUHB, to respond to these concerns.

RESOLVED:

That the Forward Work Programme be updated accordingly.

There was one member of the press in attendance.