Invitees:

 

Councillor P White – Cabinet Member Adult Social Care, Health and Wellbeing

Susan Cooper – Corporate Director Social Services & Wellbeing

Ian Oliver – Group Manager Commissioning and Transformation

 

 

The Chairperson welcomed the Invitees to the meeting.

 

The Corporate Director – Social Services and Wellbeing advised Members that when a report was initially presented to Cabinet on the subject of Homecare, it asked for regular updates on the topic in the form of quarterly reports for progress in respect of the service which was a fragile area, and also to share information as and when matters developed, with Scrutiny.

 

The report before Committee today, included a considerable amount of information, including the number of hours being committed to this service area, different trends of the service, and looking where the service presently stood and where it wanted to get to.

 

In terms of staffing in relation to the future of the service, the Corporate Director – Social Services and Wellbeing confirmed that Members would be kept fully up to speed on this as the service area changed its shape in the future. Trade Unions were being updated on a monthly basis as to any proposals to alter the staffing complement of the service to meet its future needs accordingly. Regular consultation was also ongoing regarding this with staff, and Independent providers.

 

She referred to Paragraph 3.6 of the report, that reminded Members that in November 2014, Cabinet had endorsed a detailed Transformation Plan for the service which set out the arrangements to retain specialist and complex care internally (2518 weekly care hours), and to outline that generic homecare hours would be commissioned from the independent sector.

 

Paragraphs 4.1 and 4.2 of the report, respectively outlined details of the Transfer Plan – Internal Homecare Services hours, showing current hours (Baseline) and future hours (Target) in accordance with the proposed changes to the service.

 

These hours obviously did not take into account any urgent hours for critical cases that come up from time to time unexpectedly.

 

The Corporate Director – Social Services and Wellbeing advised that as hours of the service committed internally would reduce, hours that staff were working reflected would reflect this. Further details regarding this were shown in Paragraph 4.3 of the report.

 

She concluded her submission by referring to the report’s financial implications.

 

A Member asked if there was any data available that reflected client satisfaction (or otherwise) in terms of service provision.

 

The Corporate Director – Social Services and Wellbeing advised that this hadn’t been progressed yet as part of the change in arrangements, though such information could be shared with members in due course. Engagement with service users and/or their families etc was undertaken on whether or not they were happy with the service, by way of Customer Satisfaction Forms. Records of these and other complaints or positive letters of comment made in respect of the service, were kept on record in the Wellbeing Department, and acted upon as necessary. A Consultation exercise was also undertaken with clients, and feedback received from this could be put in the next quarterly report.

 

The Group Manager Commissioning and Transformation added that when the Authority went out with its services to Domiciliary Care Agencies in a few months, this would then naturally allow for increased engagement and feedback from Service Users and Contractors, and anything arising from this again could be shared with Members accordingly.

 

A Member asked a question with regard to the number of hours the service delivered, and information regarding turnover rates as illustrated in bullet point two of Paragraph 4.3 of the report.

 

The Committee was asked to consider the suggested topics for inclusion in the Forward Work Programme for 2015-16 and to identify 12 primary topics for inclusion in the programme.  It was acknowledged that some of the dates for the items on the Forward Work Programme may be subject to change following the meeting and Members were asked for their contribution to be received in time for inclusion in the Forward Work Programme Update to be reported at the Adult Social Care Overview and Scrutiny Committee meeting on 8 September 2015.

 

The Group Manager Commissioning and Transformation, advised that the turnover rates shown in this part of the report, were based on previous service activity and including a lot of work in respect of the Re-ablement service. Some of the changes  implemented, would help people live more independently in the future. Savings projected from the change to the service were in track he added, as per projected demand. Homecare hours were not generally reducing he sated, as people were continuing to live longer.

 

A Member asked if there was an average of 15 minutes committed per client per visit from a Carer.

 

The Corporate Director -  Social Services and Wellbeing explained that some visits took this long, but this was generally the minimum, as part sometimes of a much wider package.

 

A Member noted from the report that there were no cases of Redundancy or Voluntary Early Retirement resulting from the change to the staff structure.

 

The Corporate Director – Social Services advised that this was the case, but she added that this was quite a volatile area of employment with sometimes some considerable turnover of staff during the course of any one period.

 

A Member asked why there was such a turnover of staff in the Homecare Service, largely due to cases of long term sickness absence, for example through employees receiving lumbar related injuries due to the manual handling of service users.

 

The Corporate Director – Social Services and Wellbeing advised that she would look into the reasons for this, and come back to Members accordingly in due course, though there didn’t appear to be much of a trend to rely on in terms turnover of staff during for example the last 5 years.

 

A Member once more referred to the Consultation exercise that was ongoing with staff and Trade Unions in respect of changes to the service, and asked what was actually being consulted upon.

 

The Group Manager – Commissioning and Transformation advised that the Transfer Plan and Re-Commissioning Plan were in the main being consulted upon, and that there was extensive consultation with staff and Trade Unions etc, regarding the changes and how these would affect the staffing compliment in the service.

 

A Member referred to Paragraph 4.21 of the report, and asked if the Invitees could expand a little on the Member “Champion” Scheme, that involved Elected members visiting service users and talking to care staff to help gather their views, which could also possibly be rolled out to the independent sector providers.

 

The Group Manager – Commissioning and Transformation added that a similar questionnaire to the one referred to above, was also circulated periodically to service users and more often than not, feedback from them on the standard of care facilities being provided was very positive.

 

The Corporate Director – Social Services and Wellbeing, that there were 6 such Champions, and a further report would be presented to Members in due course, on this matter. The pilot scheme for this had been a huge success she added, and though in the past the scheme had involved BCBC Home care staff, it was the intention to roll this out to the Independent Sector also. When this took place, there may be a need to expand the current number of Champions.

 

The Cabinet Member, Adult Social Care, Health and Wellbeing advised that the Cabinet wholeheartedly supported Member engagement with service users (as part of the rota visiting programme) and Home Carers also, particularly in relation to future services and programmes such as Early Intervention and Prevention.

 

The Corporate Director – Social Services and Wellbeing advised that the Social Services Department had completed its Annual Report and this would be submitted to a meeting of Council in July. There was also a meeting of the Social Services Annual Reporting Framework Research and Evaluation Panel scheduled for next Monday, and as part of that report there would be a section on Quality Assurance. Practices had been reviewed so that as part of the Homecare service review, service users had been notified of the proposed changes that were going to be implemented.

 

In terms of outcomes, a Member asked the Invitees if it would be possible at the next Committee meeting to have feedback on how the older element of society were becoming more independent and giving examples of some of the reasons for this.

 

The Corporate Director – Social Services and Wellbeing advised that this could be facilitated, not just with regard to Homecare, but other elements of the Prevention and Wellbeing agenda, and an item to this effect, could be added to the Committee Forward Work Programme.

 

A Member noted that in under future arrangements BCBC would only be catering for the most needy and for the more acute cases, whilst other less complex services would be externalised to the private sector. She was aware that the Re-ablement service was free, and asked if this would continue under the private sector.

 

The Corporate Director – Social Services and Wellbeing advised that this service was only free for a period of 6 weeks, and was normally available after a person being assessed following a stay in hospital. She added however, that this service was remaining in-house so current arrangements for this element of service would remain as is. She added that in terms of Homecare services overall, 52% was currently being provided internally and 48% by the independent sector. The latter percentage would however increase following the completion of the remodelling of the service.

 

The Group Manager Commissioning and Transformation confirmed that the last 6 months had seen an increase in capacity for the Bridgeway service, particularly in respect of supporting cases of dementia. He added that mechanisms were still endeavouring to be put in place to support individuals to live as independently as they could in a community type setting/environment, prior to them being assessed to ascertain if they require any further support initiatives over and above this.

 

In terms of the Direct Payment service, he added that further work was required to see if this could be provided as an internal rather than an external service, as there may be issues of legality regarding this. Also, what had to be taken into consideration, was how much would the Authority charge for this service compared to what an Independent provider would charge.

 

The Cabinet Member Adult Social Care, Health and Wellbeing reinforced to Members that the service area of Adult Social Care was going through a major transformation process in terms of the remodelling of the service, and that obviously arising from this, changes to the services offered and the manner in which they are provided would be made. This would inevitably involve balancing budget allocation against the various categories of care support that needed to be provided. He felt that the provisions of the report indicated that there was obviously a need for change in the manner within which services needed to be provided, but was confident that the local authority were moving in the right direction to ensure that this would be achieved.   

 

Conclusions

   

The Committee noted the report, which provided a quarterly monitoring and status update on the Homecare Remodelling Project and transformation plans.

 

• Members queried how changes to the staffing structure had been achieved without redundancy or early voluntary retirement cases. The Officer replied that savings have been realised as a result of a staff leaving the authority and that that Union representatives have been consulted and kept informed throughout the restructuring period. 

 

• Members were concerned at the rate of staff turnover and the lack of information available on exit interviews, and queried the reasons for this.  The Officer replied that the reasons for staff leaving were not always clear, but that that the rate was no worse than the Welsh average and that staff departures were hard to predict.

 

• Members asked how long social workers stayed with clients in their home, as there were concerns that some visits may be for only fifteen minutes.  The Officer responded that clients receiving a 15 minute visit would only do so as part of a much wider care package. The average visit was for one hour and some were for over an hour.

 

• Members queried the projected figure for the amount of assessed hours delivered by internal homecare services. The Officer advised that the expected timings for achieving the target number of hours may slip by a few months.

 

• Members queried where the Locality Managers are based and asked about the areas they cover.  The Officer replied that the Locality Managers are based at the Waterton depot in Bridgend and that they travel to their allocated areas from there.

 

• Members queried whether future visits undertaken by the six Elected Member Champions to service users using the internal homecare service in order to gather their views. The Officer said that the scheme had been very successful and that Members would be provided with the feedback gathered so far from the scheme and updated on plans for the scheme in future.

 

Further information requested

 

• Members requested further information about the how the Locality Managers manage their workload and provide an effective service locally while working out of Waterton.

 

• Members requested further information on the feedback gathered so far from the Member Champion Scheme and an update on plans for the future, to include information on how the monitoring capacity and arrangements have been strengthened to include a greater focus on quality assurance.

 

• Members requested that case studies be provided to help to illustrate the impact of changes to services and to evidence improved outcomes for service users.

 

• Members requested that this item stays on the Forward Work Programme with particular focus on Brokerage and how we work with partner organisation, to include feedback from clients on the quality and impact of the service and the information they receive and the outcomes that have been achieved for individuals and communities.

 

• Members requested further information on the reasons for staff leaving the service.