To
select appropriate items from the Cabinet Board agenda for Pre-Decision
Scrutiny (Cabinet Board reports included for Scrutiny Members)
Minutes:
The Committee
scrutinised the following Cabinet Board items:
Quarter 1
Performance Monitoring Report 2021
Members were
provided with the Performance Information, and the Complaints and Compliments
Data for Children and Young People Services, and Adult Services for the 1st
Quarter Period (April 2021 – June 2021).
Members
highlighted a number of the positive performance indicators, and congratulated
Officers on their hard work in achieving targets; especially given the
circumstances of the pandemic.
Reference was
made to the graph contained within the circulated report which detailed the
number of social worker vacancies, disciplinary investigations and grievances
across Adult Services. It was asked why the social worker vacancies and the
long term sickness levels were so high.
Officers
explained that some elements of the report was misleading due to the way in
which the data was presented; Members were assured that there were no current
issues with vacancies or long term sickness levels within Adult Services. It
was stated that the vacancies detailed in the graph related to vacancies across
the whole of Adult Social Care, and were not specific to Social Workers.
Officers confirmed that 20 of the vacancies were linked to the in-house
domiciliary care service; these posts originally weren’t filled as they were
being retained to support the budget issue, however over the last two years
there had been an external recruitment campaign for those posts. It was noted
that the Council had unfortunately not been able to fill them; not being able
to recruit people into domiciliary care was a national issue. Members were
informed that a further 20 of those posts were new posts which had been
established on a temporary basis from different funding streams over the last
two years; they were not vacancies within the Council, instead they were posts
that had not been established permanently into the base budget. It was
mentioned that the only vacancies within quarter 1 were 4.8 full time
equivalent (FTE) posts.
Following this,
Officers provided information on the sickness levels that were presenting high
levels on the graph (39.5 FTE). It was noted that 21.5 FTE were staff from the
in-house domiciliary care service; this was not unexpected due to the demand of
this particular service throughout the pandemic. Members were informed that the
Adult Service workforce was in the best position that it had been in for many
years in terms of sickness levels; the sickness rates were currently in single
figures.
It was stated
that the Heads of Adult Services was working with Human Resources Officers to
change how the data was presented; the data will be split into Principle
Officer Remits to try and ensure that the figures were more meaningful and
reflected a more accurate picture of Adult Services.
A discussion
took place in regards to vacancies for Occupational Therapists. Officers
confirmed that there were vacancies within this service, and that it was an
ongoing, national problem with recruitment; there had been many occasions where
individuals had opted to work for the National Health Service (NHS) instead of
Local Authorities. However, it was mentioned that Officers had recently put out
a joint advert on the NHS website in relation to vacancies, and following this
had received 50 applicants across the region. It was highlighted that Officers
were looking to provide Occupational Therapist Assistants employed by the
Council, with a similar opportunity to the Social Worker degree funding; they
would undertake a three year course at degree level, before they would be able
to work in-house as a fully qualified Occupational Therapist.
Members queried
who the Neath Port Talbot’s Children and Adult’s Quality Assurance and Learning
Framework was issued to and used by. Officers confirmed that the document was
designed for internal use. It was noted that the Customer Service Standards
detailed in the framework was developed internally with Practitioners, Managers
and Senior Mangers; however it was realised that it was also important to reach
out to the wider community such as parents, children, carers, care homes and
other groups. Members were informed that Officers carried out this work to find
out what was important to them; this helped set the outcome focused framework,
to detail what the Council was seeking to achieve and identify what difference
was being made. It was stated that the Customer Service Standards were
essentially what the service users expects of the Council; when Officers carry
out their quality assurance work, they use the questions/statements included in
the standards to ensure that they achieve what was expected of them.
It was
recognised that Neath Port Talbot’s Children and Adult’s Quality Assurance and
Learning Framework included an element which stated that key decision-making
meetings will be observed through a programme led by Senior Managers within the
service; Members asked that with the significant amount of intense work that
was currently being carried out, would Senior Managers be able to cope with
observing the numerous meetings that take place. It was noted that the quality
assurance group met on a fortnightly basis; representatives from both Children
and Adult Services attended these meetings. Members were informed that the
group had a forward work plan which listed various meetings that needed to be
observed over time; the expectation was that Senior Managers would not observe
all of the meetings at one point in time, and that it would be a phased
approach. It was highlighted that the various pressures across the service were
acknowledged.
Following
scrutiny, the report was noted.
Fee Uplifts to
Support the Sustainability of Domiciliary Care and Supported Living
Services
The Committee
received a report regarding a proposed implementation of a 10% uplift to the
fees paid to providers contracted by Neath Port Talbot County Borough Council
for the delivery of Domiciliary Care and Supported Living services.
Members welcomed
the initiative and highlighted that the Members of the Valleys Wards were
pleased to see the recognition that the Valley areas were disproportionately
affected by this problem; however, the figures were extremely worrying.
It was asked if
Officers could provide information regarding what the Council was currently
doing to ensure that those who have had their care packages removed, were safe,
well cared for and were managing to live independently. It was explained that
in the past week, the service had found itself in the most difficult position
that it had ever been in; for the first time ever, staff found themselves
having to offer individuals a place in a care home as opposed to staying in
their own home with a package of care. It was noted that there were currently
41 people in the community, who had been assessed as requiring a package of care,
being supported by family and friends; this was supported by a visit from the
Social Worker every month, weekly telephone calls, welfare checks, and the use
of the Local Area Coordinators to ensure that the families were coping. Since
September, the service had received 50 handbacks from external providers, due
to staff walking away from the job; there will be a further eight handbacks in
the next two weeks. Officers assured Members that they were doing everything
they possibly could, and offering someone a place in a care home, instead of
providing them with their care package, was the last resort. It was mentioned
that the recruitment process was active, and 10 people were being interviewed
in the coming weeks.
Officers were
asked if they were confident that the uplift was going to work in attracting
staff, and if it would be enough. It was noted that the 10% uplift was a risk
to take, and it was unknown if it would work in terms of attracting staff
and/or keeping staff in the service. Officers had spoken to every provider and
suggested a number of options to them; all of the providers stated that they
wanted some form of continuity, and they were happy to accept 10% on the hourly
rate. Members were informed that the contracted highlighted that the money will
be passed onto the front line workers; Officers will be monitoring this via the
Contracting Team.
The Director of
Social Services, Health and Housing highlighted the various risks associated
with the uplift. However, it was stated that the risk of not doing anything was
much worse; currently a lot of staff in the external market were leaving in
numbers that were affecting the ability to provide care, therefore it was
essential to try and retain the current staff. Some of the risks mentioned
included:
·
The uplift was proposed for the external
market, and not the internal market; it also did not cover residential care
workers. These were risks as staff may choose to leave the service or migrate
from one area to domiciliary care;
·
The uplift was affordable for the rest of the
civic year and the next civic year, however the ongoing funding for it was far
from clear; without additional monies from Welsh Government to support this, a
pressure will be applied on the Councils budget.
Officers
explained that they had been speaking to Welsh Government regarding sustainable
funding; this would allow the Council to uplift the living wage for all of the
care sector staff, and provide awareness and recognition of the huge benefits
that caring staff make to those people who were most vulnerable.
It was queried
whether the lack of European Union (EU) Nationals was a contributing factor to
the issues with staffing. The Committee was informed that Officers had
conducted research relating to this prior to leaving the European Union; this
exercise was completed to gain an understanding of the impact that Brexit would have on the sector. It was confirmed that
there were very low numbers of EU Nationals working in the care sector within
Neath Port Talbot; and those that did, had applied for the EU Settlement
Scheme. In regards to the staffing issues within the sector, it was highlighted
that there were a number of factors contributing to this; including competition
within the workforce, other companies/organisations offering very strong rates
of pay and employment opportunities, and the impact that the pandemic has had
on the care workforce which has resulted in individuals becoming
exhausted.
Detailed in the
circulated report it stated that there was a risk that not implementing the
same level of uplift to the Older People Care Home sector could result in Care
Home staff leaving their current employment to work in Domiciliary Care or
Supported Living due to the higher rates of pay. Members asked what controls,
if any, were in place to prevent this from happening. It was stated that at
this stage, the Council was not in a position to replicate the uplift across
the Residential Care Sector, however Officers had completed the necessary
research and had taken a view that there was more of a need in the Domiciliary
Care provision currently. The Director explained that there will be a
re-distribution exercise in the near future that will occur across the
residential care market, as the Welsh Government support funding comes to a
conclusion; the 10% uplift was a calculated risk, however the Managers in the
service were very knowledgeable for the market. Members were assured that
despite what was trying to be achieved with the external market, the Council was
taking a Council wide approach; and were utilising groups of Officers to look
at targeting various groups and bodies, such as the universities and
colleges.
Following
scrutiny, the Committee was supportive of the proposal to be considered by the
Cabinet Board.
Future of Trem Y Glyn Residential Care Home
Members were
informed of the outcome from discussions with the Pobl
Group, in relation to the continued operation of Trem
Y Glyn Residential Care Home until 31 March 2025.
The circulated
report detailed the two different funding arrangements for Members
consideration, if they were minded to approve Option 2 or Option 3; funding
arrangement A stated that Pobl
would maintain repairs and maintenance liabilities. Members asked if Pobl would be in agreement with undertaking these
arrangements. It was confirmed that Officers had been undertaking negotiations
with Pobl for quite some time; they had been made
aware of the report and were in agreement with it.
In the event of
choosing to support Option 2 or Option 3, the circulated report highlighted
that Pobl would require the Council to pay full cost
recovery; Members requested further clarification on what this implies.
Officers explained that this was the reason why the rates for contracting this
service going forward were different to the previous rates that were paid; the
detail behind this was included in the appendices of the circulated report.
Members were informed that it was agreed that if an extension to the contract
was going to be made, a separate contract would need to be developed which
would take all of the costs of running Trem Y Glyn
into consideration; this would be a standalone contract with Pobl in which they would charge the Council full rate of
the 27 beds.
The Local Member
for Blaengwrach and the two Local Members for Glynneath,
who were in attendance at the meeting, shared their concerns in regards to the
decision made in 2016 to close Trem Y Glyn, and the
impacts the closure would have on the residents, staff and the wider community;
highlighting in particular that there weren’t any other community care homes in
the Neath Valley or Dulais Valley. The Members shared
their views on the various options contained within the circulated report and
queried elements of the process leading up to the report being presented to
Committee.
Members made
queries relating to the exit strategy that Pobl were
required to develop. Officers confirmed that Pobl
were told to hold off on producing an exit strategy due to this report being
brought for consideration on various options; if a decision was made to go with
Option 1, continue with the planned closure of Trem Y
Glyn by 31st March 2022, then Pobl will need to
create the exit strategy over the next few months.
The Committee
raised their concerns regarding the transport issues associated with the
closure of Trem Y Glyn. The circulated report stated
that the Council would fund specific time-limited transport provision in proven
cases of hardship; however, it was noted that the traffic survey that was
intended to be carried out to identify potential traffic and transport issues,
was not completed. Officers mentioned that the issue surrounding travel costs
would be imbedded into an exit strategy; it was acknowledged that this will
need to be looked into, however there currently wasn’t a significant level of
detail available.
A discussion
took place regarding the current residents and staff working at Trem Y Glyn, and how this would impact on them. It was
noted that the residents and staff were at the forefront of thinking, and
Officers had been working to try and find ways of making sure they were
supported when it closes.
Officers
recommended that the Committee consider Option 3, which was a temporary
situation in which the care home provision at Trem Y
Glyn would be extended for a further year, with an option to continue to extend
up to 2025. Members were informed that the residential market place was
currently very different to when Officers last reported to Committee on Trem Y Glyn; the pandemic has had a marked impact on the
uptake of residential care, on staffing and the ability to safely move
residents from one home to another, and make assessments in a timely manner. It
was noted that the market was currently very volatile, and Officers weren’t
able to judge what the market will look like in coming months; Option 3
provided an interim position in order for Officers to better understand the
market next year, once the impacts from Welsh Government and their reduction of
funding had been identified.
Members
mentioned that they had previously asked Officers if a new build will be in
place before Trem Y Gyn was
closed; there had been no further report on this. The Director explained that
when the decision was taken in 2016 to close the care home, it was also decided
that a new care home would not be built in the Glynneath
area; however, there was a proposal in place from Pobl
to build some form of supported living. It was explained that although this
proposal might provide for the needs of some residents, it could not be
described as a residential care home or a replacement for Trem
Y Glyn. It was noted that Pobl had asked if the
Council was interested in being involved in this development from a social care
point of view for meeting the needs of older people; the Council had agreed to
this, however Officers had yet to take part in detailed negotiations with Pobl in regards to what this arrangement will look like.
Following this,
a discussion took place in regards to the future provision of care homes in the
County Borough. It was noted that currently, there was over 150 empty
residential care home beds across the County Borough; this was a significant
number of beds. Officers added that some care homes in the area had occupancy levels
of less than 70%; if this continued, these care homes would not be viable in
the future.
The Committee
highlighted that Trem Y Glyn still had a significant
demand, compared to some other care homes across the County Borough which had a
lower demand; and raised concerns with the volatility and uncertainly of care
homes in the private sector. It was noted that Trem Y
Glyn currently had around 3 or 4 bed vacancies; however, it was clarified that
the number of vacancies will be affected across all care homes due to the
upcoming dramatic changes in the market place over the next 6-8 months. Officers explained that there was a whole spectrum of
care that people will need as they get older, and some of that need was with
supported living; there were other options of care that needed to be explored
and an overall strategy needed to be produced for the whole County Borough.
Discussions took
place regarding the initial decision taken in 2016 to close Trem
Y Glyn, and the decision taken after this to build two care homes instead of
the original proposal of four; following legal advice, it was reiterated that
the options for consideration in the meeting, were those contained with the
circulated report. Members were informed that the Care Inspectorate Wales (CIW)
would not allow Trem Y Glyn to be continued in the
long term, in its current form, as it did not have the facilities expected in
modern day care homes. It was noted that discussions regarding potential
replacements would take place in the future. The Director highlighted that
going forward with this matter, Members would need all of the relevant
information regarding the strategy that was going to be taken into the future;
this strategy would capture the needs of the County Borough, however this was
not set to be developed just yet.
Following
consideration of the various Options contained within the report, it was
explained that Option 2 (enter into a new contract with Pobl
to retain Trem Y Glyn for a period up to 31st March
2025) had significant costs associated with it.
The circulated
report referenced the timely discharge of medically optimised patients, who
will need care homes as a pathway; Members asked if discussions had taken place
with the Health Board regarding their opinion on whether Trem
Y Glyn would be required in the short or long term. Officers explained that
specific discussions on the status of Trem Y Glyn had
not taken place with the Health Board, however Officers were having weekly
conversations with them in regards to the position of care homes across the
County Borough; it was hoped that after the next 6-9 months, there would be
more clarity around this.
The Chair summed
up the discussions that had taken place; and a vote was undertaken to determine
which of the three options, contained within the circulated report, Members
were in favour of recommending to Cabinet Board. The results of the vote were
as follows:
Option 1 – 0
Option 2 – 1
Option 3 – 10
Following the
vote, Option 3 was proposed and seconded to be considered by Cabinet Board.