Agenda, decisions and draft minutes

To receive any apologies for absence.

Apologies were received from Councillors Angela Russell and Linda Ann Jones.

To receive any declarations of personal interest.

A statement of personal interest was received from Councillor Rheinallt Puw for Item 6. This was not a prejudicial interest and therefore he did not withdraw from the discussion.

A statement of personal interest was received from Councillor Eryl Jones-Williams for Item 8. It was noted that it was a prejudicial interest and he withdrew from the meeting for the item.

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

None to note.

The Chairman shall propose that the minutes of the meetings of this committee held on the 13^th of June, 2024 be signed as a true record.

The Chair signed the minutes of the previous meeting of this committee held on 13 June 2024 as a true record.

To consider the report.

To accept the report, and:

1.    Note concern about the waiting lists for domiciliary care in some areas of the County.

2.    Request data regarding waiting lists across the County in order to facilitate comparison between areas.

3.    Ask the Cabinet Member to update the Committee on the work of the Domiciliary Care Project to include information about reducing costs and improving the quality of data.

A report was presented by the Cabinet Member for Adults, Health and Well-being, Head of Adults, Health and Well-being Department, Assistant Head - Supporting Communities, Health and Well-being and Assistant Head - Adults Services.

It was explained that a series of changes were currently under way within domiciliary care. Some issues had been acknowledged as needing to be addressed for some time but it was confirmed that they were now being implemented. It was explained that these modifications were now being introduced in line with the Ffordd Gwynedd review. It was noted that officers looked at the services from a citizen's perspective to assess whether or not services were effective.

It was declared that an agreement adopted with external providers, which had been adopted since November 2022, implemented a new way of working. It was noted that all providers collaborated effectively with the social workers and wider communities to offer users domiciliary care of the highest standard. This was compared to the previous working model where there was not as much collaboration and domiciliary care providers were required to work in a monotonous way to provide care at the same time of day without really considering adjustments to the user's schedule. It was emphasised that the current model allowed employees to build relationships with users and that solving any problem or need that needed to be addressed could be achieved more easily, with the support of partners.

However, it was recognised that adjusting working patterns between the above two models was challenging and it was confirmed that the department was currently still in that transition period. It was assured that employees believed that their terms of working had changed for the better in recent years and it was noted that starting to implement the new model of working had resulted in improved cooperation in community hubs deriving additional community value from the agreements. Examples were shared of how terms of working had been able to be modified such as changes in holidays and travel expenses and adjustments to shift patterns. It was acknowledged that some employees believed they were on their own and did not feel involved in relevant decisions and therefore it was ensured that the Department continued to find new ways of presenting ideas and communicating with employees to ensure input.

It was confirmed that all external agreements were now with third sector or small third sector families. It was emphasised that money was not being spent beyond the local area of the County.

In response to a query on modifications to ICT systems, the Assistant Head of Supporting Communities, Health and Well-being confirmed that four of the domiciliary care services systems needed to be modified due to the change in the working model. It was explained that the service's current systems followed the old working model and needed to be adapted to ensure that arrangements for care planning, scheduling staff hours and recording user mobility were formulated according to the new working model. Work to look into  ...  view the full minutes text for item 5.

To consider the report.

1.    To accept the report, noting the observations made during the discussion.

2.    Express concern that the provision is not consistent across the Council, and emphasise the importance of providing respite to unpaid carers.

3.    Request a further report on the review of Transport Policy and the review of Day Care to enable Members to provide timely input.

A report was presented by the Cabinet Member for Adults, Health and Well-being, Head of Adults, Health and Well-being Department, Assistant Head – Supporting Communities, Health and Well-being and Assistant Head – Adults Services.

During the discussion, the following observations were noted:

It was reported that all employees within this field complied with the statutory requirements of the Social Services and Well-being Act.

A reminder was given that there was an expectation for employees to identify individuals' outcomes as well as the best method of providing them with care and support. It was noted that individuals' personal resources, family support, level of independence, local support networks and financial considerations were taken into account.

The most common day care provision was explained, clarifying that there were three provisions within Gwynedd. These were located at Llys Cadfan (Tywyn), Plas Hedd (Bangor) and Plas-y-don (Pwllheli). It was elaborated that Plas Hedd provided day care for the highest number of individuals living with dementia and with day needs, with five individuals attending for a specialist service for two days a week. It was confirmed that 10 individuals were receiving a service at Plas Hedd with two members of staff looking after them. It was reported that four individuals were receiving a day care service at Plas-y-don and three individuals at Llys Cadfan. It was acknowledged that fewer individuals were using the service in these areas, but it was felt that this was not due to transport reasons. It was pointed out that services were being provided in other residential homes that belonged to the Council but it was stated that these were carried out on an occasional basis.

It was confirmed that it was the families who transported these individuals to the day care provision because conditions were too profound to allow independent use of taxis, but it was noted that there were some cases where taxis were used.

It was emphasised that staff had not received complaints about a lack of transport and there were no noticeable changes in attendance numbers due to transport issues.

It was noted that the Department collaborated with the Health services on a very regular basis. It was elaborated that the Health service ran specialist day care services mainly on the Llŷn Peninsula and in south Meirionnydd on some occasions. It was elaborated that 10-15 individuals attended day care provision (up to 33 individuals per week for a service that took place on two days a week) and each individual was encouraged to make their own transport arrangements. It was explained that they were doing this because the most suitable site for provision within the areas was Bryn Beryl and hospital transport was considered to be unreliable. It was emphasised that the Health service encouraged families to provide transport or rely on social transport such as O Ddrws i Ddrws or Cymrod. It was reported that Hafod Hedd (Bryn Beryl) staff were seeing an increase in the numbers of individuals attending and were not aware of anyone  ...  view the full minutes text for item 6.

To prepare an Annual Report on the implementation of the Representations and Complaints Procedure for submission to the Care Scrutiny Committee in order to scrutinise and monitor the arrangements for dealing effectively with complaints received from service users and their representatives.

To accept the report, noting the observations made during the discussion.

The report was presented by the Cabinet Member for Adults, Health and Well-being, Cabinet Member for Children and Families, Head of Adults, Health and Well-being Department, Assistant Head - Safeguarding and Quality (Children and Supporting Families Department), Assistant Head - Safeguarding, Quality Assurance, Mental Health and Community Safety of the Adults, Health and Well-being Department.

Members were reminded that the Council had a statutory responsibility to report on how it investigated and responded to complaints in accordance with the Social Services Complaints Procedure (Wales) Regulations 2014 and the Representations Procedure (Wales) Regulations 2014. It was explained that these arrangements for social services differed from the general complaints system operated within the Council.

It was confirmed that the Report shared information about the Adults, Health and Well-being Department as well as the Children and Supporting Families Department in a bid to ensure that the same arrangements were in place for both departments.

It was explained that specific criteria were used to identify which events were appropriate to respond to. It was noted that these were usually services that had been provided up to 12 months in advance of the complaint being lodged, rather than historical matters.

It was elaborated that the Stage 1 procedure was a means of trying to resolve the complaints by receiving the team manager's response and holding direct conversations with the complainants. It was confirmed that if this did not resolve the situation, complainants were entitled to request an investigation as part of the Stage 2 arrangements. It was emphasised that these were conducted by investigators who were independent of the Council but were individuals on a recognised list. It was explained that complainants could start the process at Stage 2 without going through Stage 1, noting that this was now the tendency, particularly with Children and Family cases. It was noted that if the matter could not be resolved following an investigation, it could be escalated to the Ombudsman. However, it was emphasised that no issue had progressed to this stage.

It was explained that the independent investigator was qualified, experienced and managed to deal with the complexity of cases. It was noted that there was a shortage of Welsh-speaking investigators and that this was a challenge for the service and created delays in investigations as there was a need to ensure that a Welsh speaker was available to look through information and interview individuals. It was further expanded that there was a challenge in identifying independent Welsh-speaking investigators as many of them had been working locally in the area or for Gwynedd itself, resulting in a reduction in the number of people available to carry out investigations.

It was reported that Complaints Officers and Senior Complaints Officers were available to facilitate these processes. It was emphasised that they administered the processes objectively, even though the service was located within social services. It was noted that this work could be challenging due to complainants' frustration and dissatisfaction with the service they wanted to complain about.  ...  view the full minutes text for item 7.

To receive the Committee’s comments on proposed changes before going out for consultation and submission to the Cabinet.

1.    To agree to the principle of further research on amending the charging for care policy.

2.    Request a more detailed report to include the exact figures to be charged and the charging framework.

The report was presented by the Cabinet Member - Adults, Health and Well-being, Head of Adults, Health and Well-being Department and Project Manager, Corporate Leadership Team.

It was noted that the report was intended to give Members the opportunity to pre-scrutinise an amendment to the policy before a public consultation was held and a further Report presented to the Cabinet for a formal decision. A reminder was given that the Adults, Health and Well-being Department was currently overspending and intended to make amendments to this policy to start addressing the current financial challenges.

It was explained that the hope was to have the Committee's observations on three elements of the Charging for Care Policy. It was detailed that these included:

·       Adapting the policy to add specific services that have historically been free of charge such as Day Care, Mental Health Support Service and Dementia Support Services.

·       Adapting the wording defining unpaid carers and making the clause on unpaid carers clearer. It was emphasised that the Council had not been charging a fee for direct care to unpaid carers and recommended that the policy continued to reflect that. The need to continue to support unpaid carers was identified as it reduced the burden on social services. It was recognised that there was a need to highlight what was available free of charge to unpaid carers and it was recommended not to charge for any support that was in the name of the carer. It was considered that there should be a charge for any service where there was an element of direct or indirect care for the individual receiving support, dependent on financial assessment.

·       Act on fees that were already in the policy but where the Council had not historically been charging them. An example was shared of deferred payments used where an individual entered a residential or nursing home but did not sell their home. It was explained that the person's care costs went against their property and that the Council would regain the care fees that had accrued when their home was sold. It was emphasised that the policy allowed the Council to instigate these fees as well as fees for payment administration and legal work.  It was confirmed that the Council did not charge interest on the expected fees.

It was noted that each individual was entitled to be assessed for care. It was explained that if the assessments indicated that they did not have the means to pay, the fees would be exempted. It was clarified that a maximum of £100 per week for care fees had been set for care fees for individuals and it was emphasised that no one would need to pay more than that for their care.

During the discussion, the following observations were noted: 

It was noted that it was difficult to make definitive decisions on this matter without receiving detailed data about the changes proposed to be made to the policy.

Consideration was given to whether the £100 maximum was likely  ...  view the full minutes text for item 8.