Agenda item

To scrutinise performance matters within the Department.

1.    To accept the report.

2.    To acknowledge the good work that is being done in the department, declaring concern about the Deprivation of Liberty Safeguards (DOLS) assessment figures and the waiting list for domiciliary care.

3.    To ask for a progress report on the falls protocol.

The report was presented by the Cabinet member for Adults, Health and Well-being and the Head of Department. It was noted that the report was based on the performance of the Adults department up to the end of August. It was acknowledged that the data and figures were now dated since the original date of this committee meeting, as this data changed daily. The Cabinet Member confirmed that he was reporting on the data contained in the report. The Cabinet Member thanked all department staff and in particular the large number of staff who will be working over the Christmas period. The various key partners of the department, the third sector and the volunteers were all thanked. The department's main projects were outlined noting that the department continued to deliver despite the local and national challenges, with the increasing demand and limited capacity.

Members were guided through the report, demonstrating how the department was operating to deliver on the pledges in the 2023-28 Council Plan. An overview of the day-to-day work of the department was given and information was shared about the external audits that have taken place in the period in question. An overview was given of the impact of the challenges raised in the Llechen Lân report, which highlighted the financial and operational pressures in the health and care system.

Details were given of the project to modernise care resources to meet future needs. It was noted that upgrading the residential homes at Hafod Mawddach and Cefn Rodyn had been completed, and the dementia unit at Bryn Blodau had been opened. It was noted that the dementia unit was about to open at Plas Hedd and confirmation of the opening date was expected shortly. It was noted that discussions were developing in relation to the provision of Extra Care Housing in Caernarfon, and the site had been identified. It was highlighted that the next outline business plan for the Penyberth site had recently been approved by Cabinet. It was confirmed that construction had commenced on suitable care housing development at the Penyberth site, with a view to being ready by October 2026. It was also confirmed that the refurbishments to the Dolfeurig site were progressing and that significant developments had taken place over the last few months. It was elaborated that a resource had been identified to commence work on Extra Care Housing in the Dolgellau area and that work had commenced.

Details were shared about the increasing use of technology in the department, to improve the ability of Gwynedd residents to access care support. The telecare provision was detailed on the Council's website, which allowed the people of Gwynedd to see what was happening within their communities. It was stated that over 80% of the county's telecare devices had been transferred to new digital devices, at no further cost to the county's residents. It was noted that this was groundbreaking, and this supported individuals to be independent. Reference was made to the development of the direct payments service and that this was ongoing. It was noted that new packages were offered a digital account, equivalent to a 'virtual wallet'; to be able to easily manage their direct payment packages.

A report was provided on the developments that had taken place as the Council worked with Health Services to enable people to live their best life in the community. It was confirmed that the Mental Health Service and the workforce had been established at the Council's offices in Caernarfon and Penrhyndeudraeth. It was noted that progress would be monitored over the coming months. Details were given of the effective collaboration between the Ysbyty Gwynedd Discharge Team and the Community Resource Teams. Praise was given to the good work and effective collaboration between the agencies. Information was shared about the work of the Team, as they prioritised ensuring that individuals were discharged from hospital promptly, so that they are less likely to deteriorate and consequently increase their care needs. It was explained that this avoided overprovision and therefore reduced the strain on the health service and care provisions.

The Career Pathways for residents with learning disabilities were expanded upon. The developments, training opportunities and work available for individuals in need of support were detailed, noting that the Learning Disability Career Pathway Co-ordinator worked across Gwynedd and Anglesey to promote opportunities and support individuals into paid work. It was noted that 3 support Officers were also working to promote and support individuals, and that this had been a success since the start of the project in 2023. 

The progress of the Llechen Lân Project was elaborated upon. It was noted that the research and report had been completed, reporting that other counties in Wales had shown considerable interest in the findings. It was emphasised that this work had been vitally important to look ahead to the future. Action had been ensured on the recommendations in the Llechen Lân report with several notable milestones now reached. It was noted that the recommendations would continue to form part of the Adult Department's plan which would be developed over the coming months.

The Cabinet Member highlighted that he remained Chair of the Regional Board and emphasised that the good collaboration taking place between the counties and agencies was moving projects forward quickly and successfully. Reference was made to the unpaid carers in Gwynedd and their tireless work in caring for Gwynedd residents, and it was highlighted that they needed support. It was confirmed that work was being developed to support unpaid carers.

The department was thanked for their work in supporting the county's most vulnerable residents. The developments were commended, and the challenges facing the department due to the challenging nature of the health and care area were recognised. They were thanked for the developmental work in Penrhos.

Concern was expressed about the number who remained on the waiting list for domiciliary care in Gwynedd and the shortage of nursing bed provision. It was acknowledged that the situation was worse in some areas, and it was explained that this tended to be due to the changing nature of domiciliary care. The areas of Bethesda, Dyffryn Nantlle, Tywyn and Pen Llŷn had been identified as areas of concern. This was recognised as challenging for the department and it was confirmed that the waiting list had come down since August. It was explained that staff shortage factors, due to illness and reliance on external provision, contributed to this. It was reported that the department was co-ordinating and taking action to ensure that fewer people were waiting for domiciliary care.

Concern was expressed about the Deprivation of Liberty Safeguards (DOLS) assessment figures and the domiciliary care waiting list. In response to the concerns, it was confirmed that the members had received training (DOLS). It was noted that two new officers had been appointed to support the work of reducing waiting lists in the department. It was explained that recruiting to the posts had been challenging, and individuals with experience in the field, who were keen to complete further training, had to be appointed. It was confirmed that they had attended the appropriate training and were close to completing the qualification. It was confirmed that the numbers on the waiting list had reduced, and it was hoped that they would be reduced further by the next committee meeting.

In response to an enquiry, it was confirmed that there had been a change in direct payment processes. It was asked what the identified barriers were in using these. In response, it was confirmed that this system was now run in-house within the Council. It was noted that social workers had been trained to promote direct payments, which was identified in the Llechen Lân report as the way forward. It was emphasised that the voice of the individual was crucial to this, and that the new system gave them more power and freedom to choose their own care in a way that was convenient for them. It was confirmed that this system was available to people who already had a care package. The barriers that arose with the new system were identified and it was recognised that support needed to be provided to individuals who did not have the capacity to act financially or who had no one to act on their behalf.

The flexibility and dedication of staff was praised while recognising that they often worked extra, long hours and often travelled across the county to provide care for residents. Their willingness to ensure that there was no true crisis of care in the county was applauded. It was recognised that staff were under exceptional stress and that the department was trying to respond to this by providing and offering them constant support. It was emphasised that attracting and recruiting staff was a challenge, which meant that the Council at times had to rely on staff from external agencies. It was expressed that the needs of residents were also intensifying, which increased the demand for care. It was explained that safeguarding staff and residents was a priority for the department, and that this was part of the work in looking at the condition of the residential homes and renovating them where necessary.

With the increase in Health Board employees using masks in hospitals to protect against winter infections such as norovirus and flu, it was asked if there was a plan in place to protect staff? It was confirmed that the Council had received a message from the Health Board about employees wearing masks in hospitals, and it was explained that there was not yet a demand for this in the community, but of course, people were free to choose to do what was suitable for them.

Details were provided on the Care Academy which had been launched to address staff shortages in the care sector. It was noted that it offered a professional developmental pathway for individuals wishing to pursue a career in care, while offering practical experience and opportunities for expert-led development. It was noted that a new cohort would be welcomed to the academy in the new year.

In response to an enquiry, it was confirmed that social workers now worked one day a week at Ysbyty Gwynedd. It was noted that this gave them the opportunity to work closely and continuously with patients, as part of the wider effort to discharge patients from hospitals earlier, through the Hospital Discharge project. It was explained that this gave them the opportunity to develop a close relationship with the patients and to identify their needs sooner. It was noted that this allowed them to provide proportionate and appropriate support in the community and reduced the increasing demand on hospitals. In response to an enquiry, it was confirmed that discussions were ongoing to expand the project to provide support for Gwynedd residents who attended Bronglais and Maelor hospitals in the future. A progress report on the falls protocol was requested to confirm that a protocol was in place to protect Gwynedd residents.

DECISION

1.    To accept the report.

2.    To recognise the good work being done in the department expressing concern about the Deprivation of Liberty Safeguards (DOLS) assessment figures and the domiciliary care waiting list.

3.    To ask for a progress report on the falls protocol.