Scrutiny Councillors discuss with Adult Services possibilities to work proactively to reduce emergency hospital admissions

Scrutiny Councillors on the Adult Services Scrutiny Panel met early last month to discuss the Adult Services Transformation Programme, Actions from the Wales Audit Office (WAO) Report ‘Front Door to Adult Social Care’ and the Director’s Annual Review of Social Services Charges.

Here is a summary of what was discussed, but you can view all details and reports presented at this meeting by clicking here.

Adult Services Transformation Programme

The Panel heard that since it has been an unusual year, the Programme is looking at living with Covid, including contingency and recovery but that it is also aspirational.

The Panel queried details on any developments that may have occurred in relation to assistive technology, officers responded that assistive technology plans are still in development and a briefing will be brought to the Panel later in the year.

The Panel asked about domiciliary care in rural areas, the problems associated with this and development of social enterprises. Officers confirmed the re-commissioning of domiciliary care in 2019/20 improved expansion and coverage in rural areas. The Panel heard that the Service is trying to support development of appropriate social enterprise models. A programme started last year with Co-production Wales and the Third Sector called, ‘Communities Together’ Programme, focussing on hyper local solutions being community-led, using resources on the ground to understand where there is need and gaps in provision and identify opportunities to support local businesses and individuals grouping together, to make best use of direct payments or help start-ups for local business.

The Panel queried if in addition to ‘hospital to home’ discharge schemes there is scope for proactive inter-agency assessments of people still living at home. The Panel felt that this might prevent the use of emergency admissions at hospital facilities in the first place and supply residents with the services they might get after a period of care in hospital. Officers reassured the Panel that a lot of the Directorate’s work has a multi-disciplinary team focus in the community. Officers also explained that working alongside regional work streams are the ‘Home First’ and ‘Keep me at home’ programmes which are working towards the same outcome, to prevent people going into hospital at all or if they have to, making sure that they can return home as quickly as possible and be re-abled to remain at home.

The Panel questioned the complaints process and requested to view a report showing a recent summary of the number of complaints and type of complaints received and action taken.

Actions form the WAO Report ‘Front Door to Adult Social Care’

The Panel heard that key recommendations from the audit report are being taken forward as part of the Transformation Programme.

The Panel had received an update on this in March 2020 and heard at this meeting that work around all areas highlighted then have either significantly progressed or been completed.

The Panel queried the Authority’s connection with the Third Sector/ SCVS and asked if it is contractual and if it is funded. There are a couple of funding avenues to SCVS including a number of external grants and the Authority gives SCVS core funding in terms of the volunteering service aspect and also for core work SCVS undertakes under the Compact Agreement. The Authority also has other projects with them. Exit planning post funding is now the Authority’s and SCVS’ focus, as there is a need to understand the benefit models to determine how the Council commissions going forward.

The Panel heard that the independent Advocacy Service is available to any person or carer where there is a barrier to them receiving support they need. The Panel wanted to know more about how this service is operating and officers have agreed to provide more information on this.

Director’s Annual Review of Charges

The Director of Adult Services has recommended to Cabinet that new charges should not be introduced, but an inflationary uplift to existing charges of 1.75% (Welsh Government advisory figure) should be applied. This recommendation has been accepted by Cabinet.

The Panel was informed that following the Director’s report going to Cabinet, the Service looked at learning from a test case and have undertaken a review to ensure the Authority’s charging regime is not discriminatory; officers are confident the Authority is fully compliant. This review also highlighted that the Service could do further work around transparency, in particular the mechanics of how financial assessments are carried out. The Panel requested to see the information around this and the Director has agreed to bring a further update and share information intended for publication once all work has been completed.

The Panel’s Convenor has since written to the Cabinet Member for Adult Social Care and Community Health Services and requested a written response by 14 July 2021 to the following:

  • Information on co-budget savings
  • Information and links on complaints process
  • Further information on the Advocacy Service
  • Update on work around transparency and what is intended to be published to be shared with the Panel once completed
  • Confirmation of what can be provided to the Panel this year in relation to ‘Outcomes Budgeting’.

This letter and the response due back from the Cabinet Member will be published on the Council website and can be viewed here.

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