NEATH PORT TALBOT COUNTY BOROUGH COUNCIL

Social Care, Health and Wellbeing Scrutiny Committee

9th December 2021

Angela Thomas - Head of Adult Services

Matter for Information

Wards Affected: All Wards

Report Title: Delayed Transfers of Care and Community Pressures

Purpose of the Report:

This report is in response to the Committee’s request for information in relation to Delayed Transfers of Care, for people being discharged from hospital.

Executive Summary:

This report provides an overview of the current challenges being experienced within Health and Social Care. Included in the report is information about people currently awaiting services.

Background:

Across the United Kingdom, Health and Social Care services are currently experiencing significant pressures, which has been well reported in the media. Locally, services are no different and currently Adult Services in Neath Port Talbot County Borough Council are experiencing challenges in the delivery of services. We have a number of people waiting for domiciliary care in the community. These people are currently reliant on support from family, friends and informal carers. In order to manage the risk to people waiting in the community for domiciliary care, our social work teams are maintaining close contact with individuals who are waiting and their families. This is to assess the risk to the person and to put into action alternative arrangements, such as arranging for the commissioning of a placement in a care home on an interim basis, where risks are assessed as too high. The number of people waiting on brokerage has been increased further, due to the number of people whose domiciliary care provider has determined that they can no longer provide the person with a care package. Between 1st July 2021 and 30th November 2021, 96 domiciliary care packages have been handed back by providers. This is made up of full packages of care and packages where providers are unable to support an increase to calls. Some care package hand backs, have also been due to provider issues and staff have transferred to an alternative provider, who have agreed to take over the delivery of services.

One of the reasons given by providers, for handing back care packages, is care staff leaving and providers being unable to recruit sufficient care staff, to continue delivering the service. Alternative domiciliary care packages have been sourced for some people, but unfortunately not all and some people have needed to move into interim care homes placements or are being supported by families and informal carers.

Our commissioning team is continuing to work closely with domiciliary care providers and care home providers, to try and identify solutions to the current challenges being experienced by the care sector. In addition a taskforce, led by the Chief Executive, has been established to find solutions to social care recruitment.

Adult Services in partnership with the City and County of Swansea Council and Swansea Bay University Health Board, are operating a Discharge to Recover and Assess (D2RA) model, for people requiring support on discharge from hospital. This is a model promoted by the Welsh Government and involves individuals being discharged from hospital, to recover and be assessed in the community, rather than being assessed in hospital. Further information on the Discharge to Recover and Assess model can be found in Appendix A.

At the start of the COVID pandemic, the Welsh Government stood down the requirement for Health Boards and Local Authorities to report on Delayed Transfers of Care. However operationally, managers from the Health Board and Local Authority have been continuing to meet, to try and overcome challenges to facilitating people’s safe and timely transfers of care.

Due to delays in sourcing domiciliary care for some people who are in hospital, to return home, when a person has waited five days or more for a domiciliary care package, we are offering people the option of an interim placement in a care home. As of the 30th November 2021, 13 people have taken up this offer, with nine people still in an interim placement; the longest stay has been since the 18th August 2021. The Health Board have also commissioned beds in care homes in Swansea and Neath Port Talbot and from week beginning 15th November are also offering people, who have been assessed as ready to leave hospital, but are unable to safely return home, an interim placement in a care home.

At present Adult Services have been able to commission sufficient care home placements for those people who have been assessed as requiring this level of service. However there continues to be challenges in commissioning certain placements for older adults, in particular for people with dementia requiring nursing care.

Financial Impacts:

No implications

Integrated Impact Assessment:

There is no requirement to undertake an Integrated Impact Assessment as this report is for monitoring / information purposes

Valleys Communities Impacts:

No implications

Workforce Impacts:

No implications

Legal Impacts:

No implications

Risk Management Impacts:

No implications

Consultation:

There is no requirement for external consultation on this item

Recommendations:

This report is for information purposes

Appendices:

Appendix A – COVID-19 Hospital Discharge Service Requirements

Officer Contact:

Adrian Bradshaw

Principal Officer – Integrated Community Services

E mail: A.Bradshaw@npt.gov.uk

Tel. 01639 685340