Transcript

Good morning. Good morning and welcome to this scrutiny committee this morning for social care and health. There is no fire alarm test this morning, so anybody who is joining from the council building, if the alarm should sound, it won't be a test and you should follow the appropriate fire exit signs. I wish to remind everyone present that the proceedings of today's meeting have been filmed live and may be kept on council's internet site as an archive record of the meeting. The images and sound recording may also be used for training purposes within the council. All members should have checked their headphones and microphones and IT kit before the meeting starts and all councillors who want to receive simultaneous translation from Welsh to English should click on the interpretation symbol at the bottom of the page and then click English. If members lose connection during the live meeting, please make every attempt to reconnect, however the meeting will continue so long as the meeting is core it. Can I please ask members and officers present in the meeting today to please introduce yourselves before you speak. I respectfully request that committee members have their cameras on for the duration of the meeting and not just when speaking. Before I commence the formal meeting, I would like to welcome today the first attendance at our scrutiny committee, Councillor Steve Williams. Welcome and I hope you will input into today and future discussions. Welcome. Turning to the agenda itself, first item of the agenda is apologies for absence. I'm not aware of any apologies. Have we had any? Dear, we want item two, declarations of interests including party whips. I want to remind all members that you have a responsibility under the code of conduct to verbally declare any personal interest you may have in relation to any item appearing on the agenda today. Please ensure that you clearly indicate which agenda item you have a personal interest in and the specific nature of that interest to be disclosed. You will also need to repeat your declaration of personal interests at the commencement of the relevant agenda item and indicate whether or not you will be withdrawing from the meeting during consideration of that item. I must also remind members that party whips are not allowed at scrutiny. If there is one in operation, it must be declared and members subject to the whip will not be allowed to vote on any issue subject to the whip. Members, please raise your hand if you wish to declare an interest or a party whip has been issued in relation to any agenda item before you today. Thank you very much. We will now move on to agenda item three, public questions, and I can confirm that no public questions have been received. Which takes us to agenda item four, which is on page five of the agenda pack, and our Children and Family Services update. The item is on the agenda as a result of committee requesting an update report on the actions being taken to address concerns within Children and Family Services. In no small part, as you would recall, members, the projected $7 million overspend in the last financial year. The committee is now asked to consider and receive the report. I now call, is it a cabinet member? I will now call James Tremblay, cabinet member for Health and Social Services to present the report. Thank you, James. Thank you, Chair. So in the first quarter of 2023-2024, Children and Family Services reported a projected overspend of $5.3 million against an overall budget of $23 million. As a result, a review was commissioned and led by the statutory director of social services to undertake an analysis in relation to the drivers of the demand and focus on areas where there has been significant overspend. The budget working group undertaking this work included the director of education and children services, the director of finance, the head of Children and Family Services, the head of finance, senior managers in Children and Family Services and the group accountant. It is important to note that here in Camarthenshire, we have routinely had the lowest rate of children looked after in Wales and have also maintained low numbers of children on the child protection register. In addition, we have delivered strong performance across all national performance indicators. However, not counting the unaccompanied asylum seekers numbers, our looked after children numbers have increased by 10% since January and there is traditionally, quite usually, a summer spike in numbers. Our success to date has been achieved through our strategy to invest in prevention and early intervention services. We have a strong workforce who are trauma informed and work in an attachment aware model which keeps children and young people at the forefront of what we do. We need to closely monitor all data and ensure, whenever possible, looked after children return home to their families. The historic stability of our workforce and leadership at all tiers has assisted us in implementing this model and achieving excellent outcomes for children and as a result, Camarthenshire spends less per head on children's social care than any other authority in Wales. The report of the Budget Working Group set out the increase in demand and the changing complexity of the work that has emerged in the wake of the pandemic and the impact this has had on expenditure. These changes reflect national trends. The Budget Working Group recommended that investment is needed to ensure the continued safe operation of children and family services. The report recommends that 5.5 million in 24/25 and 1.8 million in 26/27 is required to manage the increased and changed demand and a transformation programme has been developed. Even with this investment, Camarthenshire will spend less per head on children's social care than other authorities in Wales. The Children and Families Transformation Programme is being delivered by Children and Families Services through work streams chaired by senior managers. The work streams report into a fortnightly programme board chaired by the statutory Director of Social Services. The programme board reports to CMT and I receive regular diarised updates with the Director, the Strategic Programme Manager and the Head of Children's Services. The report presented to you today sets out the progress of the Transformation Programme so far and the ambition over the next four years. The embedding of new teams and new ways of working will naturally take time to achieve the intended impact and there is no room for complacency. However, this investment and the Transformation Programme will ensure the service is in a good position to be able to manage future demand and achieve a balanced budget. I will end there, Chair, but Jan Coles, Head of Children's Services is here to answer members' questions. Thank you.

Thank you very much for that comprehensive report. Can I say at the outset before any questions, Jan, there are four slides on two pages, pages 7 and page 8. Thank you for that because the information presented is extremely highly relevant and provides all the information really to some concern that we need with regards to the investment going in the Transformation Programme itself. The seven, the six work streams and critically the expected goals and targets and target dates. So all the information we require as a committee I think appears in those four diagrams, so I thank you for that. Have any members any questions at this stage? Karen. Thank you, Chair, and thank you once again for the report. My question is regarding the traineeships, which I am a great fan of, but how confident are you that we are going to achieve the no agency workers by March 2027? I know it sounds a long way away, but the way the months are going at the moment is literally around the corner. Thank you. So we have steadily increased the number of people who we have been putting through traineeships, but they haven't been enough to deal with the gaps that we've had. So we have got some staff starting now, some qualified social workers starting from, depends when they get their qualification, their piece of paper that we can start them as qualified social workers. So sometime this summer we've got some numbers starting. We're around the half a dozen mark for that. And then we'll have the same next year and then in, so that will be, where are we now, 2024? 2026. So these traineeships, they'll be starting their 18 month course in October, so come June 2026 they'll be qualified. So what we're going to be doing is, so this will be a big boost to the teams, and what we'll do then is we'll, so newly qualified social workers, as you'll be aware, can't take on all of the work, they need to undertake, they need to undertake a first year in practice, which enables them to really embed their skills and get some confidence in their work, really develop a bit before they can take on the full range of work. So we're going to be phasing out agency workers and phasing as we kind of bring those workers in. We're also being successful, so all of the jobs that we've advertised lately, and there's huge numbers of them, dozens and dozens, we've had at least one external applicant for every post. Now I think that's a real success and is a real turnaround from where we've been. I think Camardonshire has got a real success story to tell, we've got a good story to say to people, to say come and work with us, we've got a vision, we've got a good foundation, we've got investment, we understand the challenges, but we've got a supportive management team, they'll be with you every step of the way, and I think that message is really getting out there. So it's our goal, and I think we'll be there or thereabouts, I think we can be reasonably confident if all goes to plan, which I know that not everything does. Thank you, thank you, Jan. And I'm right in saying that there were salaries also in the top quarter and in the top 20%, so that's another huge positive draw. Yeah and I think that's been part of why we've been able to attract people in, those people externally now who are applying for roles, so I think the combination and the way that we're doing it right across the three divisions that recruit social workers, we're working together, there's consistency, nobody needs to hop from children's services to adult services to get a few more hundred pounds, which is important to people at the minute, isn't it? So I think that's another part of the success is that we're working absolutely hand in hand. Could you very briefly describe what's involved in an 18 month traineeship? Yeah sure, so it involves each of the applicants, and we've appointed to all of the traineeships, and we've got a waiting list of people who've got on hold, because the applicants all need to secure a placement on the master's training programme in one of the universities, and we haven't dictated which that is, that's up to them, but we've been developing a partnership with Cardiff University, we've been extremely supportive, and Swansea University will also be hosting some of our traineeships, so it's really good opportunities for people. We will be paying their fees, and paying them a salary as a support worker, so it's a huge investment in individuals, which is why we wanted to make sure, and this is the same across the divisions, we wanted to be sure that we are really attracting the very best candidates. They will work in the teams, they'll be attached to a team, they'll be long, have a sense of belonging to a team, and when they're not in uni, they'll be working in the teams. They'll do their placements here in Camarvonshire, they'll do three, I want to say three placements is it, two when it's masters, it's still three, a very short one, two longer placements, where they do a job as a social worker, as a student social worker for a period of time, and they'll qualify in the summer of 2026, but they'll have spent those 18 months embedded in the teams, so they'll be familiar with the way that Camarvonshire works, so we anticipate that they'll hit the ground running. Thank you very much. Councillor Heavens-Jones. Thank you, Chair. Thanks for the report. I'd just like to explore a bit more and delve a bit deeper into what Karen asked initially. In terms of those overarching goals of no agency workers by 2027, and it's great to hear the confidence that you have and that we're on track, but can I ask you what you perceive to be the headwinds, if you will, or what are the difficult factors or any obstacles that might scupper us from reaching that goal at the desired time? Okay, so we've been doing some workforce planning, and we know that we've got a nutrition rate of around 10 qualified social workers a year from children and families, although that has been not just people leaving the profession or leaving Camarvonshire, that's been people leaving a social work post and perhaps going into a management post, so that's included in those numbers. Because we've been rearranging the deck chairs through the kind of realignment of the senior manager responsibilities, there's been a lot of that going on, so we think that'll settle down, but that is still something that's happening right across the sector. Social workers are tired. It's a really taxing, challenging role. There's a lot of pressure involved, and if we don't manage to compensate for the challenges, the societal challenges that people are facing, additional caring responsibilities, just that pressure where people say, Do you know what? I just can't do this role anymore. If we can't compensate for that sufficiently, we'll continue to have that number of people leaving. Again, we're working really closely together on those mechanisms, and I think we really understand what our workforce needs in a good way, but that is one element that is we can't control the pressures out there. We can control the support that we give. We've just got to try and make sure that it's enough, so that's one problem. The other is that we can't recruit, so another headwind is that we won't be able to recruit the right experienced people in as well as the newly qualified people, and because the social work progression framework where we've increased those salaries for experienced social workers is new, we still don't know for sure yet what impact that will have, so that's another question mark. We think we're covering it, but this is new. These are new initiatives and it's going to take some time to settle in, so there are still some unknowns. Thank you, Jan. In relation to governance, I notice under the heading of key stakeholder meetings that there are monthly union liaison meetings. Now, obviously, any and all contact between the authority and staff representatives is welcomed and is to be condoned. I'm just curious really as to why there are monthly meetings being held as opposed to being quarterly or different times. Could you just possibly elaborate somewhat as to why there are monthly meetings with the union representatives? There is an enormous amount of change happening all at the same time. There's been almost an entire change at the senior management structure and that is in a local authority that has not been used to that kind of change. That's a picture in some local authorities, but in Camarvenshire, it's been extremely steady with people working in the same place for decades, so there's been that change right at the top. We've then got lots of new people coming into lots of new roles. We've got the programmes of change happening at the same time as doing our business as usual, so I think the intention is anything we can do that will support the understanding of the workforce, opportunities for them to question, get a greater understanding, different perspectives, we've got to bring the workforce with us, otherwise we won't deliver one single thing that's listed on this page, and I think that the unions can be a real positive facilitator in bringing the workforce with us, so I think that's the intention, Councillor, is to just use anything we can to oil the wheels of that and be as open, transparent, positive, supportive with the workforce as we can. I thank you for that and I think that it is rightly important that we are, as members, across the board, not just on this Scrutiny Committee, has an awareness and an understanding of what pressures staff are under and the enormity of the delivery of this scheme, so I thank you for that and I appreciate what you do. Are there any other questions? Meinir. Thank you, Chair. I would also like to add to the thanks for this report. It is clear and obvious what the goals are and what we can achieve and also the timeline to achieve that, and I really do appreciate that, and it's great to hear as well that you are doing everything you can to bring the workers with you so that everybody is working together on this. So I just wanted to know, when it will come to a time to looking at the budget, is the budget for this programme being monitored separately to the general budget, and when we will receive a budget report, will we receive a budget report for this department separately? Thank you. We are monitoring the budget very carefully. One of the main goals of this programme is to make sure that we manage the work that we need to within the budget that has been allocated, so we are measuring and monitoring that as part of the monitoring of the transformation programme. Because we are still so early, we have only just completed the first quarter and lots of the work that we need to do isn't actually in place yet, there is not a great deal to report on the impact on the budget, but there will be a report in the update on the programme as well as your general monitoring, so you will have two reports. So I think that this will probably come a little bit more frequently than your quarterly monitoring once we get in the swing. Except I'm reporting you quarterly, aren't I? So it will still be quarterly, but it will be an additional report. Good question. Could I - I can't see any other hands - could I ask to turn, then, to - unless we're talking about finance. So my understanding is, then, if we can confirm that the authority are actually investing £5.5 million in this financial year, £24, £25, and the best part of £2 million in 26/27, which accounts for the 7.5 million shown in your chart. So that investment is going in over a period of three years, and part of that is - part of the plan is to implement a residential services strategic programme for residential services to put in place measures to manage the current and future demand that we currently have, with the ultimate aim of eradicating the use for what's known as for-profit placements by March

1. Is that a fair summary of the residential aspect? It certainly is. Good. So what is on here, then, Chavan? Is that the building in what's commonly known as Lidegors? It's on the site. On the site of Lidegors. Yes, but it's a - we're separating it off from there, yeah. That's nigh on opening, as I understand it, and there is one other property, Glynmore Rogue, that's been purchased, and there will be another property as well. So my question really is, is the plan still on target, and are you confident that the goal of not utilising profit organisations will be hit by March 2026, because it seems extremely challenging? It is enormously challenging, and I would say that I'm less confident on this than the other target that we discussed. But I do think we need to challenge ourselves, not just because of the budgetary position, but also because it's better for the young people. It is challenging. We have got a plan, and if you just put side-by-side on paper, we've got these number of children for profit placement, and we're going to develop capacity to this number, they match on paper. But we're talking about human beings, children who have been through all kinds of difficulties, we've got to make sure that children can live safely together side-by-side, we've got to match them carefully, and I suppose that is going to be the challenge. It will be easier as we go forward with new children coming through who need residential, but it's those children who are currently in residential, whether or not, so the question first is, should we move them? Have they already settled? Are they making links? Are they making good progress? And then we need to weigh up the balance between their need to be stable and our need to reduce expenditure. So that's a fine balance, and it's part of the decision-making all the time. We're going to do our best, but I'm less confident about that, so you'll want to carefully be monitoring that and asking me as we go along how we're doing. Yes, thank you for the honesty, and of course we would appreciate that at some point it is a realistic target, so if at any point you say, well, we are going to be off target, I think it would be in everybody's interest for that to be flagged up and identified as quickly as possible. So I really appreciate the work, this is a huge programme, reflected in the fact that there's a, where did I see that? There we are, there's a programme board meeting fortnightly, so I think that that actually identifies the importance of this and how much scrutiny it's been placed under, so if things are off target, I would expect it to be flagged up in the programme board and subsequently to scrutiny, so take a bow. Jane? Just to quickly add that the team are giving a six-monthly, isn't it, and report to Cabinet, so pre-Cabinet first, so we can flow, there'll be a flow to scrutiny. Can I come in? I would just like to say as well that we can't underestimate, overestimate, I never get that right, we can't overestimate. This investment and the support that has been shown by council to the service and the people working in it has had a huge impact, it's had an impact on the morale, it's had an impact on the sense of the service being valued, the difference between people feeling that they're constantly overspending and not doing a good enough job compared to we've got a realistic budget and we're going to absolutely make sure we stick to it. I can't tell you the difference that that makes, so I would just like to say a huge thank you for your support, because it does make a difference with the workforce. Thank you, Jan, because I think the word transformation is overused, but certainly I describe it as visionary, and what's the other word I was looking for there? It's certainly visionary anyway, and in fairness I'm really pleased to hear, the committee is really pleased to hear that it's given a positive impact of the authorities' commitment on the importance of children's services, so thank you very much for everything you're doing there and we look forward to that. Steve, did you have a question? Yeah, Steve Williams, council for athlete award, brilliant report, thank you very much, as one of my colleagues said, India proof, I'm in India, I read it and it made a lot of sense to me, by the way it's my first one. Just mention about the profit placements, I appreciate obviously you've got vulnerability, you've got to look at each individual child as they come in, would we be prioritising children from the Kamar-Vinsha area into those new placements before those say from Newport County or whatever, because I know previously from my previous experience is that we were having placements from Newport, some of which had horrific traumas, one was an offender of CSA and the victim of CSA and was placed with a female and there was eventually problems there as a result of that. Is it a case that the Kamar-Vinsha places will retain the Kamar-Vinsha places in the Kamar-Vinsha homes and that if there aren't profits that Newport County, because we're talking about finances here realistically, I preach the vulnerability of the children but we need to make sure that the children that you've got big involvement with, big hard work strands going with, get that priority, does that make sense? Yeah, so these are Kamar-Vinsha placements for Kamar-Vinsha children and the whole aim of this programme is to make sure that children who for no fault of their own can't live with their family, they've been let down, they've been neglected, they've been abused by the people who should have cared most for them, they can't live with their family for those reasons, they need to be able to stay in their communities within their own culture, within their own connections and networks, that's the whole purpose of this drive around developing our own in-house placements. So these are Kamar-Vinsha placements for Kamar-Vinsha children. The only exception to that will be Havan, which it will be a very specialist provision, what we call safer accommodation and that is to support children who may otherwise be in a secure children's home, so locked up, or may have entered a Tier 4 health setting for mental health reasons, so these are children highly dysregulated, highly complex needs and who need specific and specialist care for a short period. So we need the facility because we've got to be able to support these young people otherwise they end up in terrible circumstances, but we don't need many placements so I would say that will be an exception, there may be times if there are vacancies there that we would look to offer that to our colleagues. And that would include the health service as well, an input from health as well depending on the circumstances? That's right, so we'll need to be developing a regional partnership with how all that and our regional colleagues around that, the funding for that came from Welsh Government for a regional setting. Thank you very much, and the words I was looking for earlier were visionary and radical, it's not like me not to remember the word radical, there you go, so I regard it really as those two, which I think sums it up perfectly, so we look forward to being updated with regards to the progress being made, but certainly there seems to be really positive progress on staffing and workforce which provides you with the essential tools, without the tools you can't deliver anything, so at least there seems to be excellent progress on that front, so thank you. I don't see any other hands in the question at all. Is anyone prepared to move on to the report being received? Councillor Karen Davis, and Councillor Philip Wallo, second. So all those in favour of accepting the report? That's unanimous, all hands there. Thank you very much, and thank you John. I know you have a very important meeting to go to as well, so feel excused to leave the meeting, and you're more than welcome to actually stay for this duration. Which now ticks us on to agenda item five, health and social services scrutiny committee annual report 2324, and that's on page 11 of the agenda pack, and the report's been prepared in order to comply with article 6.2 of the council's constitution, which states that the scrutiny committee must prepare an annual report given an account of the committee's activities over the previous year. The report in front of you provides an overview of the health and social services scrutiny committee's work during 2324 municipal year. So the report is in front of you, and if I could just provide an introduction to it, just to say it's my privilege as chair of the committee to present the annual report for 2324, and as you will see, it provides a fairly detailed overview, really, of the significant work that's been undertaken by this committee over the last 12 months. There have been a number of changes during the year, and that includes myself. I became chair in September 2023, and all the other changes are noted within the report. But I'd like to thank all members, former, past and present, for their commitment and their participation at all the meetings, which is evidenced, really, by the tremendous work that's been undertaken during the year. I think an increasingly important element has been that every member has the opportunity to input into an agreed forward work program, which decides what exactly we wish to scrutinize and debate, and that, I think, you'd agree, has become a very important, increasingly important aspect of the committee's remit. So the report, as you'll see, highlights the wide range of service delivery areas that were presented before you and were duly considered during the year, and that goes together with budget monitoring, the performance reports, the quality assurance arrangements, and progress updates, and specifically on the key issues that were raised during the year, and that include children's services budget, which we've just heard, and also the integration with health and the actions that have been undertaken to progress that. I'm sure you'd like me to actually recognize that the service areas within our committee's remit are as extremely challenging and a demanding environment. It's the perfect storm faced by staff for the increasing need, the staff shortages, the difficulties in recruitment, we've heard, and inflated charges demanded by certain providers, and in fairness, it is an inevitable task to try and manage that within the budget that's been set for the services during the year. I'd like to extend my personal thanks for our committee's thanks to every single member of staff, really, for their dedication, their commitment, and their tireless hard work in trying to ensure that everything possible is being done to provide those that are in need of support, that they receive the most appropriate level of care to which ultimately they are entitled. So finally, then, I must mention and praise, really, the work that went into the task and finish group, so particular thanks to the seven members who participated in that task and finish group, which made seven recommendations and 37 sub-actions with regards to addressing command and share what command and share can do to begin to address the obesity within children agenda, and that report has been presented to Cabinet for consideration late summer or early autumn. So we look forward to that. But thank you very much for the work undertaken in there. It's a substantial piece of work, and we look forward to the Cabinet receiving the report. And finally, could I extend my thanks to the Cabinet member, because of Jane Shremlett, who has attended every meeting, and all the officers as well who have been in attendance and provided us with the explanation and the expert advice and generally inputted to our meetings, which allows the scrutiny function to flourish. And finally, not least, thanks to our democratic support officer, Emma, without which none of this would actually happen. So thank you very much for your professional guidance and your general support in ensuring our meetings run smoothly. So with those few words, tikka wawdikki and anyone who would like to add or ask any questions, please do so now, tikka wawdikki. Well, with that, can I then ask, would someone please like to go then that the annual report is approved? So I think it comes to heaven, Jones first, then comes to Denise Owen second. Sorry, Brian, you just lost out on that one. Okay. So with that, can I ask a couple of show of hands, please, to approve the annual report? Tikka wawdikki, that's unanimous. Thank you very much. Thank you. So the report is approved. And we now move on to agenda item six, and that's on page 37 of the agenda pack. And as you will recall, this report has been compiled following the committee's informal session held on the 2nd of May, and it sets out the current work program for the financial year '24/'25. So the members have any comments, comments they'd like to make on the forward work program as presented? So that would be on page 41. Any comments there? It comes to Chris Davis, is your hand up? No, sorry, that did not go down automatically. I'll throw my hand now. Okay, thank you. No questions or suggestions? Sorry. Yes, thank you. You just reminded me early on, domiciliary care is at the frequency of receiving the reports, yes? Yes. So you remember we've asked for regular updates on domiciliary care performance update. The question being raised really with regards to how regular we want to report those, but because in fairness, certain elements I take it are within the general performance management report, the headline data. Jo? It was just a query because the committee received a report in May's meeting, so usually we produce them quarterly. So I think what Emma and I discussed was that you could have a report in October and in April of next year, so that you have more relevant data really, so we can have a proper discussion regarding what it's telling you. So if the committee's happy and you're happy as chair, we can rearrange that. Yes, some trends then over six months rather than a shorter period, indeed. And correct me, there are the headline figures on your standard quarterly performance management report anyway with regards to delayed transfer of care is the one that immediately springs to mind. There are. It was just that more robust, deep dive I suppose into the forecast. Yeah, if the committee's happy, then we'll just suggest that. Yeah, that's it. Members happy with that? Yeah, that'd be fine. So with that amendment, that seems quite clear. Page 42, just to draw your attention there on future development sessions. Items carried over, yes, that's the 10-year social services strategy. Suggested topics for development sessions. We've touched on this and had a discussion on our previous meetings there with regards to the regional partnership board. It's a bit wider than that with regards to the way the integrated decisions with regards to funding and integrated working between health and care and other partners are actually distributed throughout the region. So to understand how that mechanism works, who decides what the priorities are, where the resources are given to, and the time scales and the monitoring of those schemes. We're quite interested to try and understand how that process works. And so that will be later on in the year. We have the mental health immediately after this committee today. And in October, a briefing on Pentra Awil. This timetable will be very interesting and that would focus on the activities happening within, around, surrounding Pentra Awil rather than the physical building itself, which is obviously a key component of it there, but is to do with the mechanisms and the way of the progress being made there. And then we follow it through with substance misuse, et cetera. So that's quite comprehensive again. Any comment? If not, could I ask members to propose in second that this be approved? Alex, thank you. You were first and I'm spoilt for choice to leave with a second one. I'll choose the vice chair. Okay, all those in favour? Okay, that's unanimous. And the next item is on page 43. Next to item 7, to silence a correct record, the minutes of the meeting held on the 2nd of May. Is anyone prepared to move? Let the minutes be adopted. Could you raise your hands? Then comes the Denise Owain was first there and comes the Michelle Donohue second. Okay, all those in favour? Take a vote. So the minutes are approved. There aren't any other items on the agendas. The next meeting of the committee will be held on the 25th of July of this year. Thank you for your attendance. I'm now declaring that this meeting has now finished, but thank you for attending. [BLANK_AUDIO]