Agenda item

(a)       That the Committee notes the recommendations in the Audit Wales report on Commissioning of Older People’s Care Home Placements by North Wales Councils and Betsi Cadwaladr University Health Board; and

(b)       That the Committee notes the agreed actions in the Management Response to address these recommendations and receives regular updates on the implementation of the actions going forward.

The Senior Manager (Safeguarding and Commissioning) presented a report on the outcome of an Audit Wales review of Commissioning of Older People’s Care Home Placements by North Wales councils and Betsi Cadwaladr University Health Board (BCUHB).  She provided background on arrangements for the review, the purpose of which highlighted a number of continuing pressures within social care.  Extensive engagement with Audit Wales and BCUHB colleagues had led to publication of the final report which reflected a more balanced view of the position across North Wales.

In highlighting the Committee’s role, the Chair advised that the report had been considered by the Social & Health Care Overview & Scrutiny Committee.

The Senior Manager provided detailed explanation on work undertaken to date to address the five recommendations by Audit Wales, together with revised deadlines for completion.

Gwilym Bury from Audit Wales explained that councils and health boards in Wales were required to discharge their statutory responsibilities within the legal framework set by Welsh Government (WG).  He spoke about the complexities involved in nationally set fee structures and their impact on individuals.  Whilst the action plan for North Wales would help to address local issues, a separate national report to WG highlighted the need for intervention to avoid continuation and escalation of the more fundamental issues.  As stated in a previous report, Audit Wales considered that the current pooled fund arrangement to support the delivery of care home accommodation functions across the region did not provide value for money or any of the intended benefits associated with the pooled fund model.  However, it was the view of the North Wales councils and BCUHB that the arrangements complied with the obligations.  Officers were thanked for their contributions to the review.

In response to questions from Rev Brian Harvey on recruitment and retention in the care sector, the Senior Manager spoke about the success of the value-based recruitment process in collaboration with partners.  When asked about learning from the review, she said that maintaining close working relationships with care providers was a key factor in strategic planning.

Councillor Glyn Banks said that the report recognised the significant and complex work carried out by people working in social care across the region.  He commented on the potential for more collaborative working and opportunities for change influenced by WG.

In response to comments on the implementation of recommendations, Gwilym Bury advised that progress would be reviewed at an appropriate stage and that a follow-up review of arrangements across the whole of Wales was likely.  Whilst most councils and health boards in Wales disagreed with the view of Audit Wales on the approach to pooled funding arrangements, there was shared agreement on the need for national change to resolve long-standing complex funding issues within the current system.

Following questions from Allan Rainford, the Senior Manager provided clarification on governance arrangements for the Regional Partnership Board and links to Overview & Scrutiny.  During discussion on the care home market, the Committee was updated on the local situation and steps being taken to strengthen provision.

On pooled funding, Councillor Andrew Parkhurst sought an officer response on the concerns raised by Audit Wales.  The Senior Manager explained the regional approach which was supported by pre-placement agreements and strong relationships with care providers to give assurance on value for money.  The Chief Officer (Governance) spoke about the challenges in reducing cost for care provision.

As Leader of the Council, Councillor Ian Roberts said that money raised by Flintshire should be spent on local people and facilities.  He spoke about the expansion of care home provision across the County and positive working relationships with care providers.  On pool funding, he drew comparison with a similar arrangement with GwE (the regional school improvement service).

The Chief Executive made reference to the latest market stability report considered by County Council the previous day, which would help to inform future activities in creating resilience and stability in the care sector in Flintshire.

The recommendations were moved and seconded by Allan Rainford and Councillor Linda Thomas.

On the second recommendation, Gwilym Bury agreed to pass on the Chair’s request that updates include any actions taken forward by WG, along with timescales, following the national report by Audit Wales.

RESOLVED:

(a)       That the Committee notes the recommendations in the Audit Wales report on Commissioning of Older People’s Care Home Placements by North Wales Councils and Betsi Cadwaladr University Health Board; and

(b)       That the Committee notes the agreed actions in the Management Response to address these recommendations and receives regular updates on the implementation of the actions going forward.