Agenda item

To submit the inspection’s findings and the Council’s response to the Committee

To accept the reports and ask for progress reports.

 

A report was presented by the Cabinet Member for Adults, Health and Well-being, highlighting the full attendance of the Adults Department management team at today's meeting. They were thanked for their time, stating that their attendance demonstrated the Department's strength and commitment to its responsibilities. It was explained that a joint inspection of the services in the Adults Department was conducted by Care Inspectorate Wales (CIW) and the Wales Audit Office (WAO) in October 2024. It was therefore thought appropriate to submit both reports to the Care Scrutiny Committee within the same item.

 

It was added that during the same period, an inspection of the Department's work commissioned by the Department through the WLGA had been carried out and also the work on the Llechen Lân scheme. It was stated that there was an intention to bring the findings of all the inspections together and create a single detailed action plan for the Department. It was explained that this plan would in time be submitted to the Care Scrutiny Committee in order to receive its input, which was always appreciated by the Department.

 

CIW and WAO officers were thanked for their continued collaboration with the Adults Department and appreciation was expressed for their input. It was highlighted that a very high percentage of the issues identified were issues that were nationally challenging or were issues that had already been identified and the Department was trying to find solutions for them.

 

A representative of Care Inspectorate Wales presented the report, detailing the findings. Senior Officers of the Department were thanked for their preparatory work ahead of October and for the work and support during the inspection. The letter included in the Agenda (page 16) was highlighted and it was explained that this letter was the outcome of the visit.

 

Some matters included in the letter were highlighted such as the praise for the progress that had been made in the area of domiciliary care although there were further improvements to be made. It was thought that the waiting time for assessments needed to be reconciled as there were delays with some assessments for domiciliary care. The strengths and evident improvements in the area of adult safeguarding and assessment of people's mental capacity were also acknowledged.

 

It was accepted that challenges existed in trying to work in partnership with the Health Board while recognising that efforts were being made, and the importance of continuing those efforts was emphasised. Some areas for improvement were highlighted such as the challenges in recording data on assessments and support for unpaid carers, indicating that there was room to make the data more reliable.

 

A representative of  ⁠Audit Wales presented an overview of the Audit Wales Report as included in the Agenda (page 37). It was clarified that the inspection work carried out by WAO focused on matters relating to the provision and commissioning of internal and external domiciliary care. They expressed gratitude for the welcome during the visit and for the collaboration.

 

The Llechen Lân report and the plans in the pipeline were commended, stating that this showed long-term thinking and considerations to transform the Department to be more effective. It was noted that it was a weakness that this priority was not included in the Department's plan nor in the Council Plan but it was highlighted that plans were in the pipeline and that changes had already taken place to remedy this, which was very encouraging.

 

One element that was ineffective in the current system was pointed out, i.e. the tension between running an efficient service and a lack of budget and creating a service that was financially sustainable. It was noted that without a significant change, the overspending this year seemed inevitable. It was reiterated that Llechen Lân was showing an increased demand; as a result it would be necessary to ensure that the level of service was consistent and that the Council and Members received assurance that the budget was sustainable in order to avoid the need to find more reserves annually.

 

Reference was made to the risk register which recognised the risks and identified mitigation steps. It was noted that the Department was not expected to resolve all the obstacles in the near future but that measures were in place and that the waiting lists were constantly decreasing and improving. Exhibit 3 in the report on page 43 of the Agenda was highlighted which made four recommendations to the Council.

 

The Statutory Director of Social Services added that the Adults Department had faced several challenges recently and took pride in the results of the inspections being relatively positive. It was recognised that there was room for improvement and that the results of all the inspections including the WLGA inspection had come to fairly similar conclusions. It was highlighted that the Department was already aware of many areas for improvement noting that some of these areas were a challenge for the Department but it was believed that the CIW report was fair and accurate and provided an opportunity for the Department to improve.

 

It was believed that all the reports concluded that the Department was on the right track but needed to act faster. Attention was drawn to the action plan that the Department had in place.

 

The challenges in the field of domiciliary care, particularly over the last two years, were referenced and it was acknowledged that there was more work to be done in the field. It was added that the situation was improving and that a report to add the work on domiciliary care into the Council Plan would come before the Full Council shortly. The comments received from the inspectors on the Llechen Lân programme were welcomed and the inspectors were thanked for their work.

 

During the discussion, the following observations were made:  

 

Thanks was expressed for the reports. Reference was made to a suggestion at a previous meeting that the Adults Department should make greater use of the scrutiny process. It was suggested that there may be room to make greater use of the Scrutiny Committees and to change the way Scrutiny was carried out in order to be more helpful to the Departments.

 

There was concern that some of the Council's frontline workers, e.g. home carers, had no one to speak to often enough and it was asked whether the Council could give these staff more opportunities to express their views.

-       In response, the challenge of receiving feedback from staff was acknowledged, noting that these frontline posts could be solitary jobs.

-       It was explained that the Council had held sessions of thanks last year for home carers who worked for the Council. It was explained that these sessions were for domiciliary care workers who were out in the community. Ten sessions were held, and it was noted that the Department had received a lot of useful feedback. Following the feedback and recommendations it was noted that changes had already taken place such as a dedicated lunch space for staff and supervision and support from line managers. Reference was made to the hubs that had been set up in some areas to meet this request from staff.

-       It was noted that the Department was aware of the requirements on home carers and sought to act on the concerns raised by the Member. 

-       It was added that there were plans for the Statutory Director of Social Services, Head of the Adults, Health and Well-being Department and the Cabinet Member to visit the Department's services over the coming months. It was highlighted that the intention was to listen to staff and their concerns and the challenges they faced.

-       It was mentioned that work was underway to put a charter in place so that staff were aware of the support available to them at work. It was also noted that questionnaires were being sent out to staff in order to get their views on the service.

-       Reference was made to the Care Academy which had now been established to attract and support staff careers in the care fields. 

 

Sympathy was expressed with the constant challenges facing the Adults Department. A point was highlighted in the Wales Audit Office's report on a lack of adequate budget in the Adults Department and it was asked how an increased budget could be secured for the Department in light of the financial challenges facing the Council. It was hoped that this message would be conveyed to the Welsh Government, expressing the view that the Council was underfunded.

-       In response, it was noted that the WAO had produced a national report in December on the funding of the Local Government sector which contained a clear message about the difficulties that existed within the sector nationally.

-       The Head of Adults, Health and Well-being added that the aim was to act more efficiently to address the needs but that this was difficult due to the increase in demand. It was stated that there was a duty to use the available funds in the most efficient way.

 

It was commented that the report did not mention that the integrated mental health service that used to sit within the Health Authority had been discontinued. It was thought that a reference to this change should have been included in the report as it was a significant change.

-       In response it was noted that CIW's specific focus was to follow up on the issues identified in the previous inspection back in 2022 and this issue was not identified as one of the main improvements at that time. It was thought that the issue was a regional one and wider than Gwynedd as a particular area.

-       The Assistant Head of Safeguarding, Quality Assurance, Mental Health and Community Safety said that a further report on the Mental Health Service would come before the Care Scrutiny Committee in April. ⁠

 

It was asked how many officers within the Council were doing the work of assessing people for mental capacity and whether CIW believed those numbers to be sufficient.

-       In response it was noted that all Social Workers were able to carry out mental capacity assessments and that a bid has been submitted for funding to employ two additional best interest assessors to strengthen the DOLS team.

-       CIW made the point that the standard of assessments had improved.