To consider a report by the Social Services: Adults and Health Cabinet Member on the above.
Minutes:
(a) The Cabinet Member for Social Services, Adults and Health
presented a draft report on the End to End review of older people’s services.
(b) A presentation was
received from the Head of Adults, Health and Wellbeing Services in a slide
format and he noted that the direction set for the review was not new with much
of it based on existing arrangements and the Council’s resolutions over the
last few years. Attention was drawn to
the vision, nature of the vision and a series of service principles. It was
further noted that specific requirements had been set under the Social Services
and Well-being Act (2014) and attention had to be drawn that the percentage of
the older population was increasing. In
the future the budget would be significantly less than in the past and it would
be necessary to keep an eye on the impact of this.
(c) He referred to the
review’s methodology and noted the following fundamental steps:
1.
Good
Practice – to learn lessons from others on pioneering methods of operation
accepting there is no one best method in every case or field. There are several methods that may work and it
will be necessary to be wise and choose what would be appropriate and best for
Gwynedd.
2. Comparison – mainly with the
‘family’ of comparative authorities to measure progress / Gwynedd’s
performance.
3. Look at the progress not only with
hard data but also in terms of gathering information and response at a local
level.
Regarding well-being and managing
the demand, it was noted:
1. That well-being was a
responsibility across the Council, not a matter for Care Services / Social
Services only and well-being needed to be considered before profound problems
occurred.
2. The need to use intervention and
prevention as early steps on their own but these could also make an important
contribution towards managing the demand for formal care services.
3.
There
was no one general ideal answer to shape frontline services. Also integrated
methods could be included such as Ffordd Gwynedd work
at Ysbyty Alltwen and the
third sector contribution.
4. That the relationship with
communities received specific attention in the Council’s Strategic Plan. Resources will have to be directed to achieve
this and it had to be accepted that neither Gwynedd nor any other local
authority would succeed without strengthening this element of the Service.
5. That restructuring the Department
was key to the provision of services in a new way and to meet with the
expectations of the Act and those of service users.
In the context of the development
of social work practice, it was explained
1.
That it was inevitable that social work practice
would change in order to respond to the
requirements of the Act and the need to transform services
2.
Evidence indicated that culture and standard of
the work practice were key to find
appropriate and better methods to meet the needs of individuals.
3.
It was necessary to try and support individuals
to live at home with appropriate support
and over time in order the dependency on residential care could be reduced.
4.
That offering and promoting direct payments
placed the focus on the outcomes to the individual were two important aspects
when developing social work practice.
5.
That the Care Workforce Development Team had a
key role to develop the Council’s ability to achieve the changes.
In order to achieve the aims and
requirements of the Act, it was noted that it was required to strengthen the
support to live at home and focus on the following specific aspects:
1.
Dementia
and vulnerability
2.
Day
Care in Gwynedd
3.
Role
of the third sector, especially in terms of providing support in the home and in the community
4.
Home
Care – it was recognised that it was necessary to look at the correct balance
in terms of internal / external provision in Gwynedd as approximately 50% / 50% currently had an internal and
external provision and this was a cause of concern in terms of recruitment in
Meirionnydd.
Integration with NHS services may
achieve positive results, however, this may vary from area to area. It was
noted that the Intermediate Care Fund programme leads us towards better
commissioning and facilitating movement in the correct direction.
To conclude, it was noted that
the methodology was dynamic with decision to be made over the next 18 months,
some of these were strategic and operational decisions that would shape the
future and would entail huge and inevitable changes.
(ch) Members were given an opportunity to
express their comments and the following points were highlighted:
(i)
It had to be ensured that the third sector
operated across the whole of Gwynedd
(ii)
There was praise in the Bangor area for the
additional care housing provision
(iii)
The importance of including respite care
provision within the strategy to support carers
(iv)
The importance of forging a relationship with
other partners e.g. Môn / Menai the north of the County and Ceredigion / Powys
for the south.
(v)
The good practice undertaken in Dolgellau
Hospital was mentioned.
(vi)
The importance that elected members supported
the Social Services Department and
that early intervention and preventative work was vitally important.
(vii)
Would the arrangements of implementing the pool
budget be suitable and work for the changes in this field?
(viii)
Why cannot the Council operate dual registration
in order that community nurses can give them a service in residential care
homes?
(ix)
That home care worked successfully if the
facilities were available, however it was known that individuals had to move
from their home area to get residential care
provision and this caused difficulties for families to visit and to travel
etc.,
(x)
Concern regarding the lack of recruitment of
carers in competition with the better wages offered by supermarkets.
(xi)
Can lessons be learnt from other authorities
that perform better within the family, and was it possible to make more use of
private residential homes?
(d) The officers responded
to the above observations as follows:
·
Perhaps it would be possible to give
consideration to experiment with the implementation of the pool fund in certain
pockets of the County, but certainly this would have to be considered step by
step.
·
In terms of comparing performance with other
authorities, it was assured that this had been considered and incorporated in
the report’s recommendation.
·
That the scenario regarding the living wage
might possibly close the gap in the future in terms of residential and private
care.
·
Although respite care had not received specific
attention within the report, it was recognised that there was room to make use
of respite care by considering other methods to reduce the dependency on
respite care.
Resolved: To accept the
contents of the draft report and to request that the Cabinet Member for Social
Services: Adults and Health and the Head
of Social Services give consideration to the relevant comments outlined by
members in (i) – (x) above as part of the final report.
Supporting documents: