Agenda and minutes

To receive any apologies for absence.

Apologies were received from Councillors Alan Jones Evans, Peter Read and Cemlyn Rees Williams. 

To receive any declaration of personal interest.

(i)            The following members declared a personal interest in item 5 on the agenda - Cartrefi Cymunedol Gwynedd's Annual Report, for the reasons noted:

·         Councillor R. Medwyn Hughes as he was a former Chairman of the Board of Cartrefi Cymunedol Gwynedd

·         Councillor Eryl Jones-Williams as he was a tenant of Cartrefi Cymunedol Gwynedd

The members did not participate in the discussion. 

(ii)           The following members declared a personal interest in item 6 on the agenda - Health Provision in Blaenau Ffestiniog, for the reasons noted:-

·         Councillor Sian Hughes as she was employed by Betsi Cadwaladr University Health Board 

·         Councillor Elin Walker Jones as she was employed by Betsi Cadwaladr University Health Board

·         Councillor Dafydd Owen as his daughter was employed as a nurse by Betsi Cadwaladr University Health Board

·         Councillor Rheinallt Puw as he was employed by Betsi Cadwaladr University Health Board

The members were of the opinion that they were prejudicial interests, and they withdrew from the meeting during the discussion on the item.

(iii)          Councillor Dewi Wyn Roberts declared a personal interest in item 6 on the agenda - Health Provision in Blaenau Ffestiniog, noting that his daughter was employed by Betsi Cadwaladr University Health Board.

The member was of the opinion that it was not a prejudicial interest, and he did not withdraw from the meeting during the discussion on the item.

(iv)          Councillor Linda Ann Wyn Jones declared a personal interest in item 9 on the agenda, noting that she and her husband had prosthetics, and she did not participate during the discussion on the item.   

To note any items that are a matter of urgency in the view of the Chairman for consideration.

No urgent items were received.

The Chairman shall propose that the minutes of the following meetings of this Committee, be signed as true copies.

4 September 2017      (Extraordinary Meeting)

21 September 2017

(Copies enclosed)

The Chairman signed the minutes of the meetings of this Committee that had been held as follows:

4 September 2017 - Extraordinary Care Scrutiny Committee

21 September 2017

Cabinet Member:      Councillor Craig ab Iago

To consider Cartrefi Cymunedol Gwynedd’s Annual Report.  (Copy enclosed)

* 10.30 – 11.15 a.m.

(a)       An annual report was submitted by the Chief Executive of Cartrefi Cymunedol Gwynedd, drawing attention to the fact that the content of the report covered between 1 April 2016 to March 2017 and that it followed a procedure that had already been agreed with the Council.

Members of the Committee were guided through the report and the following main points were noted:

·         that the focus was on maintaining the housing stock to the Welsh Housing Quality Standard and on recommencing the work of constructing new houses

·         in each contract awarded, that contractors were expected to participate by investing in the communities and reference was made to those examples in point 4.2 of the report

·         that it could be seen from Table 1, which referred to the various elements, that the work on average complied in full with the WHQS, although some elements did not hit 100% and the reasons for those failures were explained

·         reference was made that some tenants refused to allow work be carried out on the houses and that this was acceptable, unless the work was to be completed in line with health and safety

·         that statistics were submitted to Welsh Government on an annual basis 

·         in terms of the construction work, many partners were being collaborated with and in relation to grounds maintenance, the contract had been awarded to Gwynedd Council and the work done was very good

·         that work was being done on strategic subjects such as: homelessness (18 houses transferred on a lease to use by Gwynedd Council); provision of affordable housing (a total of 39 units and over 100 houses being achieved this year by using a social grant); growth plans and it was emphasised that there were opportunities along the North Wales coast that assisted CCG to achieve more  

·         that there was good collaboration with North Wales Police and specific reference was made to a scheme and arrangements in place in Maesincla.

·         Reference was made to the strong links between houses and the health service specifically in terms of facilitating timely and easier access to mental health services for some tenants 

·         In terms of the repairs service, although this had not been up to standard in the past, he had received a specific focus to improve the service and reference was made to success in point 9.5 and performance had improved and the service was now much more productive and customer satisfaction had increased

·         That CCG was inspected annually by Welsh Government and that it was pleasing to report that the inspectors praised the service and that they had excelled in terms of financial viability      

(b) During the ensuing discussion, the following points were highlighted by individual Members:

(i)       It was expressed that the general complaint by many Members was a lack of follow-up to the complaints of tenants, specifically relating to community spaces, windows not opening.

In response, it was explained that the standards of customer care had improved but that it was obvious that some problems continued and he  ...  view the full minutes text for item 5.

Cabinet Member:      Councillor W. Gareth Roberts

To consider a report on the above matter.   (Copy enclosed)

* 11.15 – 12.00 p.m.

(a)  A response was submitted on the above matter along with:

·         responses to the recommendations made by this Care Scrutiny Committee on 21 September 2017 

·         A letter from the Chair of the National Assembly of Wales' Petitions Committee  

·         The Report of the Petitions Committee dated 22 January 2018

(b) The Cabinet Member for Adults, Health and Well-being welcomed the report of the Petitions Committee that approved the six recommendations of this Care Scrutiny Committee made on 21 September 2017.

(c) The Area Director (West), Betsi Cadwaladr University Health Board referred to recommendation (i) in Appendix A of the report and confirmed that the Health Board had achieved the recommendation and the information had been shared with the Scrutiny Committee.  

(ch) In relation to recommendation (ii), namely the request for an immediate report on the health provision in the Blaenau Ffestiniog area from an independent agency, a Member drew attention to the fact that the Petitions Committee noted that 98% disagreed with getting rid of beds.    During the ensuing discussion, the Committee was in agreement that the best way forward was to keep to the original brief and ask the Community Health Council to undertake the task of investigating the health provision in the Blaenau Ffestiniog area and provide a report of the conclusions.   However, there would be a need to ensure at the same time that they were prepared to fund this.

(d) In the context of receiving information about the services provided in the new Memorial Centre in Blaenau Ffestiniog, the Assistant Director Initial Care explained that a post-project evaluation would be undertaken to see whether the services had reached targets within the business plan and this would be reported back to Welsh Government.   As part of this work, responses would be gathered from the service users and if any weaknesses became apparent, a response could be given. 

          The Cabinet Member for Adults, Health and Well-being added that it would be beneficial to submit a report on the conclusions of the evaluation of services in the New Centre to this Care Scrutiny Committee, and it was reported further, subject to the results, that the Care Scrutiny Committee could hold a further investigation.  

In response to an enquiry regarding how the residents of Blaenau Ffestiniog and the Blaenau Memorial Hospital Defence Committee could have an input, it was noted that complaints could be lodged as part of the procedure, however, it was ensured that a specific engagement process would be created at the end of the summer term to ask for feedback on the experiences of the services at the new Memorial Centre since its opening.   It was also added that the Community Health Council could undertake this process as well.    

          The Assistant Director Initial Care was of the opinion that the services were excellent in the new building which included therapists, pharmacists, services collaborating together in a more stable way by now as well as the recruitment of a general practitioner.

          In response to  ...  view the full minutes text for item 6.

Cabinet Member:      Councillor W. Gareth Roberts

To receive an update on the progress and development of the above scheme.   (Copy enclosed)

*12.00 – 12.20 p.m.

(a)          An update was provided on the progress and development of the above scheme and the Gwynedd Senior Adults Manager guided members through the report, noting the progress made in terms of implementing the integrated working model, the Alltwen Scheme.   It was pleasing to note that elements had moved on with good examples of various teams working in a different way.   The five areas where the integrated plan would be rolled-out to were listed, namely:       

Bangor Area

Caernarfon Area

Llŷn Area

Eifionydd / North Meirionnydd Area 

South Meirionnydd Area

           Members were given an opportunity to ask questions and the Gwynedd Senior Adults Manager responded as follows:

(i)    It was acknowledged that there was a need to consider extending the hours of providing the integrated service over seven days.   It would be challenging to implement an extension in working hours and days within the current workforce without additional staffing resources.  Care had to be taken that any changes to hours did not impair the ability to respond effectively during core hours and that they were in-keeping with the principles of retaining ownership of a case. It was intended to complete further work having established the service within five areas in order to see the nature of the demand for support outside normal office hours and on weekends and identify the skills needed to meet the need outside core hours.  The Senior Adults Manager referred to an example of measuring the demand in relation to considering extending the working hours of home carers overnight in the south of the County. The majority of the calls related to the need for nursing skills and the examples of a need for the carers service were scarce.

It was noted further that an out-of-hours service was already operational across Gwynedd and Anglesey.

(ii) In terms of the timetable for the provision of a single integrated electronic system for the teams, it was explained that the Social Services department was using the new WCCIS system since August 2017.   There was an intention for the Health Board to join soon, but the Senior Adults Manager could not specify a date.  It was agreed to ask the Senior Transformation Manager for an update on the timetable. It was added that there were challenges in terms of recording the information bilingually and this could complicate integrated working at times. 

(iii)   For further information, the Corporate Director referred to the 'Parliamentary Review of Health and Social Care in Wales' under the leadership of Dr Ruth Hussey, and it was encouraging to note that the above format provided a good foundation for work and coincided with many elements in the report.  

          Resolved:                     (a) To accept, note and give thanks for the report.

                                       (b) To ask the Gwynedd Senior Adults Manager to send the contact number of the Integrated Teams in the five areas to the members of the Scrutiny Committee. 

                                                     (c) To ask the Head of Adults, Health and Well-being Department to invite the Scrutiny Committee members to visit the  ...  view the full minutes text for item 7.

Cabinet Member:      Councillor W. Gareth Roberts

To receive a report by the Cabinet Member for Adults, Health and Wellbeing on the above.

(Copy enclosed)

*12.20 p.m. – 12.40 p.m.

(a)           A report was submitted by the Cabinet Member for Adults, Health and Well-being, outlining the findings and recommendations deriving from an investigation held on the type of support available to unpaid carers in Gwynedd.

(b)          The Adults and Children Carers Support Officer guided members through the report and noted the main points as noted below:

·         That Carers Wales had appointed an officer for the North to promote the identification of hidden carers

·         That the Gwynedd and Anglesey Carers Partnership Group had drawn up a strategy and one of the objectives was identifying hidden carers

·         Assessments would continue to be undertaken and an attempt would be made to do this as soon as possible 

·         In terms of feedback from carers, fewer than 100 out of 500 questionnaires had been returned and the responses to the questionnaires returned by the carers of individuals with mental health issues were relatively encouraging  

·         In terms of information and advice, it was noted that guidance had been produced and was back on the website to draw attention of staff / carers with relevant links

·         We were collaborating with Betsi Cadwaladr University Health Board

·         An additional grant had been received from Welsh Government to provide respite care for carers however attention was drawn to the fact that there was an insufficient number of people working in the field to provide respite care, specifically in Meirionnydd.

·         That savings and cuts were affecting the service. 

·         Welsh language - that documents received from the health service needed to be translated into Welsh, and some providers were experiencing difficulties in recruiting Welsh-speaking staff, particularly in the south of the County. 

Elected members were encouraged to inform the service whether they were aware of hidden carers in their wards who looked after family members so that the service could offer them advice.

(c)           Members were given an opportunity to scrutinise the report and the Adults and Children Carers Support Officer responded as noted below:

·         it was asked whether the service was fit for purpose and in response, it was noted that the requirements of the new Act were challenging, and there was a need to collaborate with partners in the field.   The need to be realistic and attempt to focus on two or three of the objectives were needed.  

·         It was reiterated that addressing the requirements of the act was important and the need to consider how the best value for the money could be obtained by reviewing and prioritising 

·         In terms of addressing needs and supporting young people who were carers, there was close collaboration with Bangor University which offered a period of respite for young carers so that they had a taster of what was available and to encourage them to gain a qualification in care.   In addition, there was collaboration with the Regional Group. 

·         From the grant of £114,000 received for 2017/18, £60,000 had been shared with the third sector and the rest supported carers with learning disabilities, Derwen and carers who cared for a sibling.

·         In response  ...  view the full minutes text for item 8.

Cabinet Member:      Councillor W. Gareth Roberts

To consider the final brief for the Investigation and to elect members. 

(Copy enclosed)

*12.40 – 12.50 p.m.

(a)          A brief was submitted for a Scrutiny Investigation in order to support the disabled people of Gwynedd and specifically the suitability of the arrangements for providing wheelchairs to Gwynedd residents as well as the service for individuals with prosthetics.    

(b)          The Area Assistant Director Therapy Services (East), Health Board, explained that prosthetic provision had been offered in the past at Bryn y Neuadd, Llanfairfechan, and that there was a need to review the location where the service would be provided to the residents of the western area, be that at Bryn y Neuadd or at satellite clinics in Bangor, rather than having to travel to Maelor Hospital, Wrexham.   For clarity, attention was drawn to the fact that the name used for the service was now the Posture and Mobility Service, rather than ALAC.   It was explained further that the structure in Wales regarding the provision of wheelchairs was within the procurement arrangements of Welsh Government and that the decisions did not lie within the Health Board's remit. 

(c)   It was explained that the matter had been raised when Councillor Peter Read had submitted a notice of motion from the Council referring a question regarding the suitability of the arrangements for providing wheelchairs for the residents of Gwynedd for consideration on the scrutiny programme.

(d)  In response to the above, the Members Support and Scrutiny Manager thanked the officers of the Health Board and the Committee was asked to nominate five members to serve as part of the investigation.

(e)  In terms of nominating, advice had been received from the Senior Solicitor that a member and / or a member with a family member, who received a personal service from the wheelchair / prosthetics, should not be a part of the investigation as it would be difficult to separate interest and personal experiences from general considerations.  

(f)    Councillor R. Medwyn Hughes and Dewi Roberts agreed to be a part of the investigation but because of the personal interest of many members and other people's commitments and work pressures, no other nominations were forthcoming.    Therefore,  it was suggested to hold a further discussion at the informal meeting regarding the possibility of sending an e-mail to all Members to identify nominations from members who were eager to be a part of the scrutiny procedure, in order to reduce the workload of the existing scrutinisers.   

Resolved:                     (a) To approve the final brief for the Scrutiny Investigation on Supporting the Disabled People of Gwynedd, and for the prosthetic provision to be included.

                                       b) To elect the following members to serve as part of the Investigation: Councillors R. Medwyn Hughes and Dewi Wyn Roberts and to discuss further at the informal meeting to attract further nominations to serve on the investigation.

To submit, for information, the scrutiny forward work programme, as it stands at present (copy attached).

*12.50 – 13.00

* Please note that these are estimated times.

Submitted, for information, this Committee's forward programme as it currently stood.

Resolved:                     To ask the Chairman, Vice-chairman, and Members Support and Scrutiny Manager to discuss with Heads of Service on including items for the next meeting of the Care Scrutiny Committee to be held on 8 March 2018.