Agenda item

To consider the report

DECISION:

·       To accept and note the progress on the findings of the Internal Audit review of the Council's Home Care arrangements 

·       The thorough Work Programme that was in place to improve the provision was welcomed.

·       Further updates would be required in 12 months on the progress and the success of the work programme.

Following on from the findings of a Special Internal Audit commissioned by the Chief Executive into domiciliary care in Cyngor Gwynedd, an update was received from the Head of Adults, Health and Well-being Department on the detailed work programme that had been drawn up to prioritise and strengthen the provision, and to improve the effectiveness and efficiency of the Council's arrangements in the domiciliary care field. It was noted that the work programme included 63 Sub-projects within the work-streams of the Domiciliary Care Project Group (which had been established under the leadership of the Head of Department, to address the work and address the issues requiring attention in order to give confidence that the model of providing domiciliary care worked effectively). It was reiterated that there were three main streams to the work programme, which included internal provisions (15), systems and processes (22) and embedding the new model (26). Those sub-projects relating to the WAO Audit were submitted to the Committee only, i.e. waiting list, spending / financing and contract monitoring, and a progress report was provided on those projects.

In response to the Committee's observations in asking for assurances that the Care Scrutiny Committee had considered aspects of the domiciliary care field, the new model in general and its impact on residents, it was noted that a report had been submitted to the Scrutiny Committee in September 2024 to support the desire of the members of the Care Scrutiny Committee to weigh-up the effectiveness of the domiciliary care provision across the County, particularly in terms of maintaining and improving services for residents.

In response to the internal audit, it was noted that there were assurances and clarity from addressing the matters raised, and that there was an open invitation for internal audit to attend Project Group meetings.

In the context of the block hours, it was noted that the hours were regularly reviewed jointly with the Finance Department and that the risk register had now been simplified to reflect priorities and effort. It appeared that the waiting lists highlighted a trend / pattern of reduction, which gave the impression that the new model was going in the right direction.

It was reported that the Care Inspectorate Wales Inspection was keeping an eye on the quality and standards of the Service, and Audit Wales was publishing their findings on the arrangements for Domiciliary Care 06-02-25 - the recommendations of these inspections would also highlight matters to improve, which would need to be coordinated with the work programme.

⁠The Head of Adults, Health and Well-being Department expressed that the domiciliary care field was volatile and challenging, and the issue was being given substantial attention and investment in order to improve. It was reiterated that the Department was taking the matter seriously and improvement priorities had been set.

The Chief Executive took the opportunity to reiterate that the efforts to seek order had derived from a response to a concern in the domiciliary care expenditure monitoring procedure and Internal Audit had been commissioned to look at the situation. As a result, it was noted that a work programme had been formulated and that changes were afoot in an attempt to improve the provision, accepting that some of the arrangements had been weak. Now, with the clear recommendations of Internal Audit, the problem had been identified and a remedy to the situation had been proposed - the block hours were being given particular attention and the waiting lists were reducing. He reiterated that an update on the situation was to be presented to him at the end of 2024/25, as well as ongoing discussions at the Department's performance meetings.

Gratitude was expressed for the update, the information and the full response to the situation.

During the ensuing discussion, the following observations were made by members:

·         An adequate budget was needed for the work - the overspending was concerning⁠

·         That there were substantial shortcomings in the Department's administration - there was a need to ensure that the matter was being supervised. Were there assurances that the shortcomings had disappeared and/or assurances that the money being paid out was correct?

·         That data was being used appropriately - accepted that information shortcomings had existed, but assurances were needed that the new model secured correct information in order to better manage and monitor the situation.

·         That there was a need to ensure that success was being measured.

·         That an update was needed on the progress and success of the work programme.

RESOLVED:

·         To accept and note the progress on the findings of the Internal Audit review of the Council's Home Care arrangements. 

·         The thorough Work Programme that was in place to improve the provision was welcomed.

·         Further updates would be required in 12 months on the progress and the success of the work programme.