Agenda item

(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 about the objective to continually seek improved performance and referred to a joint approach with partners to adopt a more consistent approach to thresholds for adult safeguarding.  The Committee had made representations to reduce DFG delivery times and whilst the positive Occupational Therapy response rates were welcomed, other elements involved in the DFG process were noted.  In seeking a reduction in delivery times for DFGs for children/young people, some example case studies had been shared with the Committee which highlighted the various complexities contributing to delays.  Recognition of good performance on the assessment and support for carers was also welcomed and would continue by working with voluntary sector partners and carers’ organisations.  Focus on improvements for outcomes of looked after children had resulted in some progress, with further strengthening required, and had been also been highlighted by the Children’s Services Forum.  Attention was drawn to improved performance over the last quarter in relation to Personal Education Plans (PEPs) and an increase in health assessments for looked after children.

In relation to comments on changing leadership, the Chief Officer agreed to circulate the revised Social Services management structure to all Members, at the suggestion of the Chair.

Councillor David Healey thanked officers for the report and the progress made.  He referred to the Council’s tasks in seeking further improvements on the areas identified and also to focus on the three key areas to be reviewed by CSSIW, asking if there was an opportunity for more involvement by the Committee.  As a new Member of the Committee, he asked if an item on mental health issues could be considered.  The Chair acknowledged the request and said that local Health Board representatives, including the mental health services team, had attended meetings of the Committee.  The Chief Officer agreed with the need for focus on this particular subject and spoke about the joint management arrangements between the Council and local Health Board.  There was a good network of services in place to tackle Dementia issues and the Child & Adolescent Mental Health Services (CAMHS) team had attended Children’s Services Forum.

Mr. Gifford highlighted the delivery of services for people with a learning disability as one of the national reviews to be undertaken across Wales.

Councillor Christine Jones reported that the Double-Click scheme, involving mental health service users, had recently become a social enterprise.  She spoke highly about the service and urged other Members to visit.

Councillor Hilary McGuill acknowledged the areas of good performance but expressed concern about the delayed implementation of the SPoA initiative.  She pointed out that delays in the delivery of DFGs for children/young people affected the individual and their carer, and had raised an issue with the Senior Manager: Children’s and Workforce Services about the allocation of suitable accommodation for care leavers.

On the SPoA, the Senior Manager: Integrated Services, Lead Adults explained that Denbighshire Council had been a demonstrator site at the initial stage.  In Flintshire, the service was currently operational in Social Services with additional staff expected from Housing colleagues.  Negotiations with the Health sector had resulted in a commitment for additional resources to support full implementation by March 2016.

In response to comments on the disparity of costs paid by different Authorities for nursing home provision, the Chief Officer said that he would check but that the rates for Flintshire corresponded with those in Cheshire.  He added that residential care fees was a topic of ongoing national debate and that charges to Councils were around 30% higher but expected to reduce over time.  He went on to speak about his involvement with the Chief Executive on working jointly with the Health Board in recognition of the pressures faced by care homes on recruitment.

The Chair referred to her involvement with the Council’s multi-discipline board to review residential care homes.

In acknowledging the areas of good performance highlighted in the report, Councillor Dave Mackie commented on the challenges which could affect some issues relating to looked after children.  As requested, the Chief Officer provided information on the Regional Adult Safeguarding Board which had sub-regional input from Flintshire and Wrexham.

The Chair remarked on the areas for improvement in section 1.18 of the report and asked when the new framework would be introduced to Members.  The Senior Manager: Children’s and Workforce Services explained that the new national outcomes framework was to be introduced from 1 April.  This would be achieved by evaluating the experiences of individuals and collating information to share with Members.  It was intended to bring a report to the Committee before piloting this approach.

RESOLVED:

(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.