Health & Social Services Scrutiny Committee - Thursday, 2nd May, 2024 10.00 am
May 2, 2024 View on council website Watch video of meetingTranscript
Good morning Councillors and welcome to the scrutiny meeting for social care and health. There is no fire alarm to test plan for today so for anybody who is joining from a council building, if the alarm should sound, it won't be a test and you should follow the appropriate fire exit signs. The meeting, I'd like to remind everyone present that the proceedings of today's meeting are being filmed live and may be kept on the council's internet site as an archive record of the meeting. The images and sound recording will also be used for training purposes within the council. All members should have tested their microphone and IT equipment before the meeting starts and every Councillor who wants to receive simultaneous translation from Welsh to English should click on the interpretation symbol at the bottom of the page and then click English. I take it for granted that translation is working. Shall the meeting be a English language webcast will receive Welsh to English simultaneous translation automatically and 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 coded. Can I ask members and officers present in the meeting today to please introduce yourself before you speak and can I also respectfully request those online to have their cameras on for the duration of the meeting and not just when speaking. Der Waow, thank you very much. So moving on to the agenda itself, apologies for absence. I am aware that Councillor Tremblet, the cabinet member for health and social services, is unable to be with us today due to health and our best wishes for a speedy recovery. Are there any other apologies received? Okay, Councillor Riveen Roberts is trying to join the meeting and hopefully will be able to join us soon. Any other apologies? No? No? Thank you. Moving on to a agenda item two, declarations of personal interests, could I 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 the interest to be disclosed. You would also need to repeat your declaration of personal interest of 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, a member subject to the whip will not be allowed to vote on any issue subject to that whip. Come members, please raise your hand if you were to declare an interest or if a party whips has been issued in relation to any agenda item before this today. No one, thank you very much, shall we proceed to item three, public questions, and I can confirm that no public questions have been received. So move on to the first substantive item on the agenda, agenda item four, which is the revenue and capital budget monitoring report for 2023, 24, and that's on page five of the agenda pack. So our committees are asked to receive the budget monitoring report for the health and social services department and consider the budget reposition, which indicates that as the end of February, there is a revenue overspend of £9.7 million, £6.9 million within children's services and £2.8 million within ADERT, which if you look at the report takes the, I don't wish to steal cabinet members' thunder on this, but if you look at the report, it takes the net expended, forecasted expenditure on social care within commodities to £144.5 million with a total expenditure exceeding £200 million for presumably the first time. So at this point, I'll now call along the cabinet member for resources, Councillor Arlin Lenny, to present the report to us. Thank you very much, Chair. As you have noted, the spend is significant, of course, on the services, apart from education. This is the biggest. And the forecasted budget, as you said, is an overspend of £9.7 million. Appendix A on page 9 shows a summary of the services and the variances from the budget. The forecast budget overspend on children and family services is an area of significant concern to the corporate budget position, and while recognising this, a working group has investigated the reasons so that the current demand on children and family services can be understood. A transformation programme for children and families has been developed to set out the overall strategy for children and family services to manage future demand, to meet statutory obligations, and to achieve a balanced budget. Appendix B shows the most significant revenue variances, followed by the full detail in Appendix C. The projections for the capital budget are on pages 19 to 21, and show a projected underspend of 267,000, which is primarily due to slippage on the Carter of Conest Development Project. The summary for the capital budgets are in Appendix D and the details in Appendix E. Appendix F outlines the progress in delivering the proposed efficiencies for this year. At the moment, 1.4 million is considered to be deliverable with an unmet target of almost 600,000. Thank you, Chair. Thank you very much, Alan. Right, if I can ask members if you have any questions you'd like to put to officers or the cabinet member with regards to the budget, I suggest we go through it. Appendix A to C first. So, if you can start on page 9, I'll go through each report, and if you have any questions, please put your hand up. So, anything on the summary on page 9, which is, I think, the cabinet member took us through, so moving on to page 10, which gives us some detail there on adult services, physical disability services. Any questions? Chair, thank you. So, page 10, the notes advise some of the overspending result of the external staff agency costs on your developing and in-house agency pilot for the schnetly-based homes. I just wanted to ask how this is progressing. Please, Diyolch. I will be in a position to respond to that. Sorry, I didn't quite get the end of that question of apologies. There's no suspend and they're developing an in-house agency pilot for the schnetly-based homes to be rolled out in April 24. I was just wondering how it's progressing with a timescale, because it was saying with a view with successful of deploying it across the county this summer. Diyolch. If an officer is present, hopefully, who might know the latest on our efforts there to nurture more of our own staff, of course. I have been part of this pilot and things that have been progressing and everything has been set up on Egresso and everything. So, we are looking to start that very soon. So, by next time, hopefully, we'll be able to give you a better update by next time. Thank you very much. So, it has been set up and it's a bit early days to see what the outcome is, but things are moving forward. Yes, they are. It's very early days at the moment, so hopefully, we can give a further update. Chair's microphone. Is there anything from Appendix A to C? We'll take those appendices first. Any further questions for members? Brian. Thank you, Chair. I just want to ask, maybe explanation has come, but there is the reason for the biggest overspend is the agency staff. What happens about that? I'm sure we're trying to employ more internally, but is the figure reducing because there is a lot of overspend on the agencies. Thank you. A good question. Dylan Jones, group accountant. As I've said, it is early days for this pilot, but we officers are looking at when we need to get internal workers back from agencies, and we are scrutinising that much more now, and also when the pilot comes in, hopefully we'll see results coming from that over the next few weeks and months. Thank you. I should have said Councillor Brian Davis. I was just thinking, is there an eagerness from current staff to take on more hours? Is that something that can be considered at all, or is that not possible? To be honest, we would have to look into that and come back to you. We wouldn't be in a position to answer that at the moment. Thank you. Councillor Alex Evans. Sorry I didn't see your hand up there, so apologies if we've been kept waiting. No, I haven't been to a no problem. On page 12, if I could ask about the mission residential placements with a forecast overspend currently at over 3.5 million. This is a significant portion of the department's overall deficit overall. I understand it was doing really good work as a Council in creating in-house capacity going forward due to the extraordinary costs of going through private companies for these placements. The only question I had really is we actually forecast in our future budget forecasting how much we'll actually see if year on year going forward, so even for the next year or two, by creating this in-house capacity, that we're actually able to say that based on this capacity being created, we'll see if X amount on this deficit on this particular item. Thank you. Thank you. Thank you, Chair. Thank you, Chair. Thanks for the question. It is a concern for us, of course, there are cases which have very complex needs and there are no places in Wales for these young people. We have to provide places in units outside of Wales and it costs about 20,000 a week in one case that we are aware of to look after one individual who does have very complex needs. We are trying to develop a course within the county to provide for a lower level possibly and it's difficult to say at the moment and it's hard to know from year to year really how much money to keep for this because maybe next year there would be less cases or possibly, you know, if there are one or two fewer cases, it might mean a million pound less to find but one of the officers might be able to answer that in more detail giving an overview really of that. Thank you, Alan. John Coles had a children and family services. So children services is a demand led service and what's really important is that we have the strategies, the policy framework in place to enable the teams to manage that demand effectively. We've seen the demand since the pandemic change and increase and we set that out for you previously in the budget report for you in some detail. We now have strategies in place to going forward, make arrangements to be able to manage that demand effectively and equip the teams to be able to manage that demand effectively. What is happening though is we have more children here in Kamala Sher who need residential children's home placements than we have had previously and so I think if you go back looking at 15, 20 years over the numbers, what you see is that a dip comes maybe five plus years ago, even ten years ago, I don't have the papers in front of me, I can clarify those numbers specifically but a dip comes so those numbers go down. At the same time we've got a swelling of foster care in numbers which gives us more option and choice for foster carers for foster care placements. So we were able in Kamala Sher to manage those placements for children, provide them with what they need in a different way so there was a dip. When that dip came in our use of residential placements, the budget dropped with it, what we didn't do was think, right, there's a dip now but what might come down the future and so what we've got is an overspend where there used to be a budget if that makes sense. So what we're doing, we're doing a number of things in concert. One is we're introducing our early help services which will help us manage, we're increasing capacity in our social work teams which means we can work more effectively with families because we've had this swell of demand in social work teams and we haven't met that with social work capacity. We also then need to increase our foster care placements as well which took a massive slump after the pandemic and then at the very tip of the end here of the spectrum we're developing our residential children's homes. So what I'm fairly certain of as much as I can be is that by doing all of these things together over the next five years we'll see an improvement in that position where we're not going to need to be at the mercy of profit-making providers who can name their price and we're in an enviable position that we have to just meet that price to enable us to meet our duty to those children. We're going to do all of those things together and we will see that improvement over time. This whole strategy is to enable us to manage demand to support children and their families and to do it within the budget that the Councillor set. I'm really hopeful that we're going to be able to do that because I think we've got the right answer to the questions and the challenges that have been posed to us. But more specifics than that Councillor Alex, I can't give because I do come back to a demand-led service and we could have right now somebody coming through our front door a family of seven siblings, a family of nine siblings, a family of five siblings, one of whom might need a residential placement and we will have to pay whatever the cost is right now for that. But the strategy that we've put together is going to help us manage that demand on the line. A convoluted answer to something that's a really complex situation. I hope that makes some sense. Yes, it does. With the benefit of hindsight, if we predicted the impact of the pandemic, I think we in every year authority and government were invested earlier. But that's the benefit of hindsight. I bring Cezanne Nolan in here. Cezanne Nolan group content for education and children services. And Councillor Evans just to clarify as well that within that budget for the 24/25 year, you'll be aware of the significant growth that's been allocated to children's services. And one of those key areas is around the residential placement, the balance of the immediate need and also then the longer term funding as the new children's homes and new strategies come into place. So that's all part of the transformation plan. And that's a key area for Jan and the team then to work through that increased budget and identify and review with the actual demand and the services then that will provide that in the most kind of cost effective way as the needs change as well. Thank you very much. And I assume that this ties in to our generation 7 as well, the early helped strategy to get all fits in. Thank you very much. Here comes the current Davis. I'm on the same page, the next one up, the unaccompanied asylum seeker children. Obviously we've got quite a large overspend and my concern is have we reached the maximum of asylum children that we are going to receive? It's an excellent service but we must be mindful that we're not having, we're having to spend more than the income that we receive from government. So no, we haven't reached the maximum yet. We think given the ratio that's provided to us by the home office, the figures that are provided, we will have around a maximum of 37 children. So that's under 18s in our care and a company designed seeking children in our care at any one time. When we reached that number, then that's our maximum. So long as that still remains the correct ratio of the number of, the total number of looked after children we have at the time. However, those children are constantly growing older as we all are. So whilst they may be under 18 at the point of referral, within two years, three years, four years, they will become 18, which means our number of, that 37 number drops and we need to take another intake in. So that number is moving all the time. The young people are moving through from being children, that under 18 number, which is a maximum of 37, through into over 18s. There is no maximum number of over 18s that we require to support. So the challenge for us is to make sure that we very quickly ramp up those support services. So we're not doing the ad hoc spot purchasing of provision for those children and that's where we are. And you'll recall that in the budget setting process and the report that I did last time, one of our priorities is to be developing our services, running a company designed seeking children, so that we can deliver that within the home office budget and we're doing that in a variety of ways. Sorry, Alex, I think I cut you off there. You did have your hand up. Yeah, sorry, Chair. I just wanted to say thank you to officers. I can't remember for the answers. I just wanted to kind of explain as well. I fully appreciate that the demand will dictate the actual size of the office panelist particular item. What I was asking is, do we have an idea on average of what, say, for example, you know, a home we create in slightly, can't wait to seven people. If that home was fully occupied, do we have an idea on average, what that actually save us? If they'll save them, how to go into private accommodation instead is what I was more getting at. As in, do we have an idea on average what each home will save us compared to what it would cost with private accommodation? If that makes sense. So I appreciate the overall demand. It's impossible to know what the overall number will look like irrespective of how many poems we create. Thank you. No problem. Before you come in, John, that is the business case. Are we establishing the homes in the first place? Exactly. So that is the business case. So our homes will cost us per head depending on the number of children. So we'll have different homes that will meet different needs. So we'll have a different number of practitioners supporting children in the different homes. So the unit cost for each home will be slightly different. But it will be certainly cheaper than the costs that we're paying per unit for most of our children at the minute. So we're paying 12,000, 13,000, 14,000, 20,000, 32,000 pounds a week for those various placements that we have. None of our in-house placements will cost anything like that. There'll be around the six and a half, seven thousand pounds a week unit cost depending on how many children are there. We won't be making large institutions. Those days are thankfully, mercifully behind us. So these will be, will be replicating so far as we can a family home environment where children can live with a firm set, consistent group of staff who will be their kind of replica family if you like in those homes. So that's the challenge for the team. We do it in the best value that we can possibly do it. We have got the the costings profiled, Councillor. We do have that detail. So that what we know is that we've got plans for young people. So we've got a young person who's in a 12,000 pound a week placement. We know that as soon as we can get Glen Murug up and running, then we'll replace that unit cost. That young person will be moving to Glen Murug and that will have almost that weekly cost. So we've got that profiled into the budget which will enable us to deliver a balanced budget this year. So we've got those things profiled in. There are a number of moving parts in that. Not least, we've got to get Glen Murug up and running. But we're doing our very best and working with colleagues across the council to do that. Yeah, we've got it profiled in the in the in the budget for the next couple of years. Yeah, that's brilliant. Thank you very much. Well, before I bring the cabinet member in, my only question would be are you confident of your ability to recruit sufficient numbers of staff? We've been really fortunate these last months. I've had team members, Karen Barlow-Satt here, who's been doing this work as well, where we've been wall to wall and end to end week to week interviewing. We've had a really good response. We've recruited to about 80% of the posts that we've advertised for the residential children's homes, which I think is phenomenal. And I think what that does is shows that we've got something really good that we want to offer. People want to come and work in a place which puts young people's well being at the heart. And we're making no apology for what we're doing is about placing children's needs at the centre of this. So, yeah, I'm confident that we'll be able to recruit most of the team that we need. Excellent. Thank you, Ali. Very quickly, chair, looking at the picture nationally, as you know, following the collaboration agreement between Clyde Comrie and the Labour Government in Wales. There is a commitment to delay the private profit from the children who receive care using a not-for-profit model instead. And this, of course, is by starting, of course, by concentrating on care homes for children and foster carers. Thank you. Just to look at the picture in general. Right. There are other questions on appendix A to C. We move on to appendix D on page 19, which is the capital. One thing. Members, have any questions on capital? I was a candidate, yes. On appendix E, the purchase of Placer Bren con guillier, this is the first time I've noticed it, could I have an update on how it's proceeding, please? Then it's been led by Alex Williams, who's leading the Pentra AWL program as well as Head of Service. We have a working group. We are consulting with English counties to examine how they've proceeded with the development of a local authority care home, because it'll be the first one in Wales, if we do proceed with looking at nursing care being provided as well. So we're looking at different models to ensure that it's workable and looking to see if we can see different strategies of how they've been set up. But the idea is that we will look at providing nursing care from that home as well. So there will be an extension built on it and obviously a refurbishment of the current home, and it's in the early stages, but we're looking to see whether we go as far as providing nursing care as well in that home. So we're looking at different models really across different areas, and if we do proceed, it'll be the first one in Wales to provide nursing care. But the local authority can do that. Thank you for that. Just as a local member, I knew about the purchase, but I haven't been informed of any further developments. Of course, people know that it's been sold, and I am starting to have questions, so it would be if possible kept in the loop as regards any further information. Yes, of course. It is in the very early stages of looking at what exactly will be there, but it will be obviously a care home, providing dementia care, residential care, and possibly nursing care. Okay, but I'll make a note to that. Thank you. So I take it, once the details are finalised, there's a lot of, obviously, discussion between health, look at the situation, which in ourselves and health, and lots of other issues as well, but once we have a detailed programme and a timeline that the local member and the community will be informed. Yes, most definitely. And I'll speak to Alex to make sure you're kept. Thank you, and thanks for the answer. And thanks for the question, Karen, as well, and it is important that local people know exactly what's going to happen here. As we've heard, the plan itself hasn't been completed yet. We did buy the home, which went for sale, because as you know, it was closed by the company that was in ownership before that. And we were happy to approve that purchase, but it is important that local people know exactly what is going on. And as a cabinet member responsible for assets, I will work with the officers to make sure that the information, as much as we know, is distributed. Thank you. Thank you very much for that promise. Okay, Karen, thank you. If you further questions on those appendices, we move on to Appendix F on page 23, savings model report. Members, any questions on that? If not, this then Appendix F, as well, which gives the detail. So if I don't offer the questions, can I thank everyone for their questions and for the officers for their input? And can I ask you, is it so prepared to move the report be received? Because the current Davis, and can I ask for a second there? I think it just comes to the Phillip Wallo. No seconding. All those in favor, please raise your hands. And that is unanimous. Thank you very much. So the report is received. I will now move on to agenda item 5, which is the Thomas Hillary care performance update. The context in January 2003 committee requested a regular performance update regarding Thomas Hillary care provision within the county. The report in front of us is the fourth report to be provided. And I understand that Jane Thomas, the senior delivery manager for long-term care, will present the main issues within the report, and then I'll invite members to ask questions. So if that's okay with everybody, Jane, can I ask you if you introduce the report? Thank you very much. The report provides a key data related to the number of hours commissioned by Dom Silvergate. The number of hours waiting for Dom Silvergate and the number of people waiting in the community for Dom Silvergate and the number of people waiting in possibly for Dom Silvergate. The in-house Dom Silvergate versus the external providers, the report covers the continued recruitment and retention challenges with regards to home care. However, following a robust and sustained recruitment program in January 24, we've seen an increase in the number of applications to our home care posts within the local authority trend, which has continued throughout quarter four. We're also seeing an increase in the number of overseas worker applied posts by sponsorship, which we have not been able to support. But the conversion rates from application to appointment remain lower than we would have hoped for. But we are working with that. The services focus in on strategies to promote expansion of the in-house services and recruitment and retention challenges have been having an impact. But this is obviously the same across Wales and the UK. It's not just for commodities. And at the moment, we're currently providing 37% in-house, but we aim to get up to 50% of the market. And we are promoting, we're focusing strategies on that promotion, expansion, but the recruitment and retention. We are focusing on that and we've got an active campaign going forward to continue the progress we've made in quarter four. So, for mitigating the risks for the weightiness, there's still a need for us to manage the risk. And we are therefore continuing to review those waiting for care to ensure the needs have not changed. And people remain safe throughout regular, by regularly keeping in touch. And we've appointed for what we call care and support coordinators. So, anybody waiting for care will be allocated to care and support coordinator. And they are contacting anybody waiting for care every seven to ten days to check that their needs remain the same. And they still manage you without care, unless the person themselves, as I, you know, some people say, I really don't want to call every seven to ten days. You know, can you ring me once a month or can you ring me when the care is available for me to receive? But that gives us assurance that people are not waiting and we don't know if they need to change it, if that makes sense. We're also continuing with our release in time to care methodology, which, to actively reduce the care packages, we're appropriate and release hours to support others. So, that team focuses on our double-handed care calls and the occupational therapists review and ensure that there's appropriate equipment and we may be able to reduce those care packages from two carers to one carer. It's working very well. People find it very positive. People have less intrusive care because they're only having one carer coming in instead of two carers and they find that their independence is promoted and that is working very well and we do reduce care packages in that way. We have a fortnightly meeting that takes place to review the long hospital weights. This allows us to challenge and review and ensure that all options being considered. This has had a considerable impact on reducing the hours with those waiting in hospital and in addition, there are twice weekly hospital escalation panels where all difficult cases are escalated for discussion. We also offer the delta connect and direct payments to both the person needing the care and also to the carer who is providing the care to support them whilst they're waiting and to support the carers with their own needs whilst they are caring for someone who is waiting for care. And everything I've just mentioned is helping us to manage the risk of those waiting on our waiting list. Do you have any questions? Thank you very much and to inform committee you've stepped in a very short notice really good for the A, the cabinet member and B, Joanna Jones as well. So thank you for attending a very short notice. Thank you for the report. So correct me if I'm wrong before I ask invite questions. So what you've outlined there in the report is that in terms of all the key indicators, everything actually has shows an improvement and that's the key indicators being the number of hours commissioned, the numbers of people waiting in terms of people and the hours involved and of course critically as well those waiting in hospital for advisory care. So those are the other big headlines that you reported to us. There's also been a significant decrease in the numbers waiting for social work assessments which is also a huge positive and but with all those positives there are even though there are less people waiting for care and the number of hours have decreased there is still a significant amount of people and met need and that you need to monitor to ensure that they're in a safe environment prior to the certain to to services being being provided. Is that a fair summary of what you just outlined? It is a very good summary. Yes. Thank you. Thank you. So with that, I remember. So first of all, Minaire? I just want to ask a question that you raised in your presentation there on page 38 at the bottom of that page about foreign workers. We are unable to support them. Can you just possibly explain what that means? I'm not quite sure why we're not able to support them and what does it actually mean? I'd have to speak to the domiciliary care manager Julie Tekken and ask her to respond to you because I don't. I wouldn't want to say something because she manages all of the recruitment of the domiciliary care workers. Would that be right if I could do that and ask her to feed directly back? Yes, that's fine. No problem. That's fine. Have you a supplementary measure of the owner? No, that's fine. We can see then from having an explanation what it does mean and why we're unable to support them. Maybe another question will arise from that but I appreciate that we do need to get the right information. Thank you. In a range for all the adequate response. Thanks, Chair. The questions that I have are on page 39 mainly. It's pleasing to hear about the increase in the applications for post-up to the end of financial year. It's good that the focus is on the strategy to increase to answer 50% of the demand in the market and to develop resilience in the system. We are talking about a robust approach to sickness management. Can you possibly explain a bit more about what that robust approach means? Thank you. James, a question is about to explain what does a robust approach to sickness management actually mean in practice? I do feel that, again, I'd like to refer to Julie Degan because I don't manage the home carers. The dormitory carers. I, again, would like you to have a full response. I can talk about our well-being services and our employee support meetings and our occupational health support but I really would rather it came from the Drex CD Manager if that's okay. Yes, that's fair enough. Are we talking then? It's in productivity to ensure cost effectiveness. In relation to that increase in productivity, would you be able to sort of give us a few examples of what that might entail and really what's the journey been so far in what we tried to strive for? So we're developing the home-first base, home-first model of care and we've got different pillars within that home base. So we've got a community assessment service, we've got the re-agreement service and we've got the release and time-to-care service which I've already discussed. But with the re-agreement service, we're looking at flow from hospital or prevention of hospital mission or people who have are new to Dominos Enrique. So they've had a sudden functional change and we're trying to develop a flow through the system by using rehabilitation strategies with people. So they stay within the service for up to six weeks or longer if we can see progress is being made. But the aim is that people are given the confidence to promote their independence to maintain their own care and then we can support somebody else then and people might stay in the service for two or three weeks because they're given that confidence and independence. So we try to create flow through the re-agreement process and then we've got the community assessment service which is similar and but that's provided by the private sector and again they have an ongoing assessment for six weeks with a multidisciplinary approach around them weekly meetings so that we can be productive in supporting people to gain their confidence and not become dependent on carrying the long term but obviously if they if they do we then put a long term packaging and that's what the six weeks assessment process is. Yeah thank you I'm glad that you mentioned that that if the care is needed because from the point of view of seeing a close family member sort of rely heavily on Dominos if you care I very much feel that you know it's got to be a service who's a led approach. So I mean I'm glad to receive the assurance that it's not rushed in any way that it's tailored to meet the needs and continues to meet the needs and I'm grateful for that. In relation to the reference to direct payments made to service users or providers of care I'm not sure if you could answer this now but is there an estimate of how many such cases are there and what proportion of those are actually just actively waiting for for care packages to be provided I've been looked after by a family member etc. I don't know the exact number and I wouldn't I could guess but I don't want to guess because of the arena we're in I'd rather get the I have an idea but I'd rather get the proper number and bring it back to the next meeting or or feedback due directly but direct payments is processed straight away. So we within the local authority there's a team that managed the direct payments and and the the people who manage that actively start to look for a PA's personal assistance for that person straight away. So we don't have many people who wait long because the majority of people will know somebody who they want to employ as a PA so once we've identified the need and they decide that they want to proceed with the direct payments it's it's usually a family member or somebody living in their local community and we can proceed straight away with employing that person going through the recruitment checks because DP direct payments is it is sort of owned by the person themselves a lot of people will start employing that person at risk because if they're trying to do so and we will back date the payment once we've had all the recruitment checks in but it's because the person themselves is the employee you know so is the employer so they they can take that risk if they so wish but we do we don't monitor that very carefully and we do discourage it but sometimes they're implying a family member and they know that a DBS check is going to come back here and and so forth and sometimes they're implying a family member where they they know there is something on their DBS check and we will the social workers will discuss that with the people but there isn't a long delivered direct payments if the person no somebody wants to be implied they want to imply you know thank you Jen I think the question so much for clarity of the question of the truth is manager yeah I don't think it was so much like we have in much of delay in direct payments very reassuring that people facilitated to to employ a PA you know as a matter of course it's a matter of how many people are waiting for domiciliary care for instance and employ a PA what's the question how many people have resorted to utilizing direct payments because they're waiting for a care package that was the essence of the question yes sorry I don't know the figure off the top of my head because obviously that's an ongoing process but usually when people have accepted the direct payment as as a meeting for domiciliary they've actually kept the direct payment because it's worked well for them so and they haven't reverted back but it isn't a figure I think we've kept to be honest about how many people have you know because this this process we've got in place has been been in place now for at least two years or since we've started giving direct payments as an interim so I don't think that's something we can't like to speak to our quish team to see if we're interested in all how many basically we're here to play how many use direct payments as as an interim as before it's a true recognition it may those who continue with direct payments have made that choice we take the point how many do it or temporary support grateful for the detailed response that you gave and that's been insightful in itself in terms of understanding the process and the way people decide to approach it and retain it but I think I really would be keen to have an insight into whether people are using it as a stock cap if you will why they wait for domiciliary care because you know not everyone are fortunate enough to be in a position that they have friends or families who can commit to a long term commitment of caring so sometimes I 'd imagine that it is a stock cap and it'd be nice to see how that fits into the bigger jigsaw thank you thank you sorry Kevin yeah the Calvin Barlu senior manager for children services and a lot of social care in relation to the previous question around direct payments I'd suggest I know there's a similar question in the previous session from the members one suggests perhaps that in a future meeting we bring a detailed report in relation to direct payments across the different groups and and how many are in receipt for what type of support I'll probably answer your questions yeah and immediately following this meeting we have committee have a develop have a discussion of a forward work plan which include development sessions that could well be a subject area of members may may decide what they need further further information or a deeper dive on so thank you for for for volunteering that thank you very much you may not do it again moving on I don't see any any other hands so is anyone prepared to move that the report as presented by by jb received heaven and the knees second about so would all members please show breeze in your hands that you're in favor of receiving three port all hands up can ups that's unanimous so the report has been has been been received they're allowed and thank you very much for for the report chain so moving on we now move on to agenda item six which is the task and finish group report entitled an active and healthy healthy start so if I can give a brief introduction detection to this you have the report in a substantive report as a financial report in front of you and it's all stems from the publication of some really alarming data indicating that commodities are at the highest levels of overweight children in Wales and committee as a result of that decided in July 2023 to establish a task and finish group which comprise of seven committee members to research and make recommendations as to what realistically could be undertaken directly within and by the authority to begin to address this huge issue so over a period there were nine actually meetings have taken place and the findings and recommendations are before you within the report and as a member and a chair of the group I would like to personally thank each and every member and every officer for your work over this extended period of time and producing such a detailed and substantial report with an extensive range of recommendations and actions worthy of serious consideration by cabinet for action so thank you all officers our members for your input and your work has culminated as you can see in the report in seven key recommendations with 37 subactions again before we actually discuss the report particular things have to go and appreciation have to go to the professional those professionals individuals from outside organizations and authorities mentioned on page 8 they're all mentioned there the evidence that those people gave and the research that they actually presented to the task and finish group was sobering to say the least and to summarize the the report itself as I alluded to earlier how well they are at 29.2 percent as the highest proportion of overweight and obese children age four to five in Wales with commodities being the highest of those three counties at 31.4 percent of four to five year old children's and those figures are extremely stark we've got to emphasize it's not as easy as as telling people to eat a balanced diet and to exercise I'm told there are nearly a hundred reasons and factors at play that actually have an influence and actually directly on on obesity and that ranges from medical conditions to medications to a whole range of in many cases interrelated issue so it's not a matter of one or the other or both is far more complicated than that the scale of the challenge however from the research highlighted by the task and finish group it's highlighted within our own data this year in literature and the report is focused on what can we do as an authority with regards to this subject matter there are big issues here with obviously at the process food and food labeling which are governmental issues so you're very easy to actually put the focus on there but there's nothing that directly we can do so this report as I'm sure you've noticed in the recommendations subactions are all within the authorities remit but the scale is huge so for instance how many of us were aware that 87 percent of preschool children are below average or poor in their motor competencies and I wasn't fully aware what motor companies actually were until I was on this group it means running jumping throwing catching a balance is all things that we take for granted our children can actually undertake that's really but that's not the case and that's been measured by a validated motor assessment tool now that predicts that that predicts high in activity levels and that does a direct link then of risk of poor health trajectory in adulthood likewise less than half of our 73 73 schools that were surveyed comply with the recommended two hours of minimum time for physical education with 23 offering 60 minutes or less and on similar themes school swimming attendees have almost halved over the decade for nearly 80 percent to pupils to 34.8 percent but on a real positive the group have been really really impressed by the number of projects and initiatives that already been undertaken locally when we're in the county to address these issues and the survey recommendations there to say is imperative that all those initiatives already been undertaken carry on the threat the weather is in the fact that most of those are dependent on short-term funding what used to be European funding and now more recently SPF funding which all have relatively short timelines and implication that has for for instance the come Gwenbraith project youth services very heavily on on grant funding and the risks associated if if what funding were withdrawn so as I said I'm done to summarize this is an extremely complex subject matter and it requires a totally holistic and strategic and operational multi-agency alignment of everything that is a everything has been done at the moment and be linking into emerging strategies you know the big hit there's being the new prevention strategy which is currently at early stages of development the maternity and early year strategy for West Wales and our own local food strategy all those are key strategies which must interline not only strategically but operationally to allow what's currently been undertaken to both be grow and actually make best use of resources and produce far better incomes so as I say the report makes some key recommendations and they are around stakeholder governance which is bringing everything together they're considering a prenatal and preschool age which is absolutely vital primary schools the community sport the school swimming provision for the healthy eating and addressing inequity which is currently within the county because some areas have very successful pilots what other areas both have that provision some areas have ample play areas and playgrounds and etc community sporting facilities that they don't and they suggested that we use the opportunity to penetrate our wellness alternately bring us to concentrate particularly on the most applied area in the county and to use the the advantages and the opportunities petera will will bring on this agenda and finally a fit for future infrastructure to enable children's and families to actually be active so dear about that we have similar to the port so now over to the members for any questions think about correct dear could i read this isn't a question this is a compliment to those as I wasn't on the committee so I can quite easily say this that what has come out of this report throughout from the committee is outstanding as a pharmacist I see the children preschool and primary school age who are actually struggling through ill health because of inactivity and I really do hope the cabinet will back this because it is something that we can do throughout our communities so well done everybody who took part and you know the members would like to comment or raise any issue on here before I ask officer this he and he and george said the leisure is here and and he had it when there was I thanked in the report generally there is having massive input into this along with other officers from your from your section so dear about Ian heaven or the other one shall be did Ian want to go first or no? I'm pleased that the chair has mentioned thanks to the officers because as one who was part of the process it was an education and it was a pleasure to be part of the process as well I'm pleased that the chair has talked about the operational side of putting these recommendations into action and that is can help with some of the concerns which would come in the future the chair did refer to equity and I feel that there are some things in the current financial climate which are threatening that equity and one concern I have is relevant to recommendation three where it talks about what happens specifically in primary schools we all know as part of the consultation on the budget that was last time there was talk about various things that are discussed in the education sector about the possibility of a cut in relation to the budget per head per pupil I think in the context of equity that is a real threat because not every primary school isn't in the same position in relation to their capacity to face a cut per head for the pupils and don't have the same capacity in being able to provide what is in the recommendations when they are facing such cuts so is it a time for us to consider if there will be a cut is it a time for us to consider various situations of schools what resources they have what opportunities they have locally instead of that happening across the county on a flat level if you like in the context of the recommendations in this report are we looking at a position of schools individually the size of the schools the type of the school so in order to put these recommendations into action I think we as an authority on be ready with the schools thank you yes that is a fair question it's probably it's not for us in scrutiny to actually do this is that there are implications for all these recommendations what I should have said better than something very important I didn't actually say that somebody is that this is we've the the committee of the liberty operated within the context of assuming that there's no extra money so even though there's 37 subduction all these recommendations sub actions that it's all in the context of the financial reality that that we are in at the moment so rarely this doesn't ask for company to invest half a million pounds in this in this initiative what it does ask for is could you please consider these recommendations of how we can actually undertake this he was been undertaken at the moment we trip with our policies at the moment because the council haven't defined policy on swimming for instance and that every child at the age 11 should be able to swim I forget the the length now but that's that's policy was confirmed comparatively recently we've got the figures here to say well the numbers actually achieve enough are falling we've also got the data of of that activity levels generally even though it's accepted the prevention exercise is probably one of the best prevention preventative options you can take to secure your health facts are that activity levels physical activity levels are permitting and be that in sport or you know across the board so but come up to your direct question yes there are recommendations here which have implications both operationally and financially on education and schools what you mentioned this is is very apparent and that is what obviously cabinet will have to take into account on the wider issue really of how much of this should it be these recommendations be adopted and what are the implications operationally for each and every school because not every school is in the same situation but what I've been very impressed with and that's not just a leisure department more than anything is the immense amount of data that we already have between leisure education of activity levels in school there's a wealth of information out there some of which is in the report with regards to participation in certain activities some schools participate proactively other schools don't and there's a whole it's one of the recommendations there's a whole raft of work needs to be undertaken really is to understand our current position understand it the the implications of it and work through basically and I think I'll bring you in here you'll have to work through school by school basis and then is it doable isn't it and if it isn't why long windy answer to say yes these are things the cabinet will have to get the grips with and be satisfied on why when they consider this report which I think is in July I think timetable for July I completely agree the pressure I think I think that would equities important if we are going to make sure of that we can't take an approach of one size fits all we have to and the cabinet will have to look at the size location situation of every school individually and I think it's important that this work does happen dear sorry Ian to put you on the spot do you want to add anything further something I possibly haven't mentioned in the summary or respond to heaven anyway yes one of the things in relation to equity is the inconsistency that we saw and it's not just relevant to schools it happens in other places before children reach to school before they reach school like nurseries etc so there's obviously an inconsistency and I don't know that whether that's demographics of the area sometimes in relation to schools is because of the size of the school or how the school is managed who their teacher is you know there are many aspects that do influence it but there is obviously inconsistency and what we are saying in the report is that the work that we want to do specifically with the education department and school is just to try and make sure that they do sign up really to these recommendations and say that every school needs to provide those opportunities regularly because obviously some children are missing out and some are not there's some schools bring them swimming some don't some do schools after activities after school some do two hours of PE I think it's one of those basic things really in the agenda for the county this might sound but when you talk about the well-being of future generations well basically this is it and one of the other statistics in the report is that it is four times more difficult to change a pattern of how people behave by the time they are in year four compared to when they're four years old so that's you know four years old up to eight years old you know it's four times more difficult to change behavior in that very short period of time so we have to try and do something as early as we can in their lives and do that on a regular basis so that was one thing that did stand out for me and as you said Gareth as chair we have tried to write this understanding that there is no additional money unfortunately from us as a county and nor the other sectors but what does happen is that there is a lot of good work excellent work really the concern with that is if that work didn't happen where would we be now and how worse off would we be but obviously there there are opportunities to work better together and I think we need to approach that there are pockets of good work happening over the county in various areas different sectors but I think with better governance hopefully we'll be able to do that on a more consistent basis and get the best out of the resources that we do have be it staff provision facilities etc that we try and do the best of what we have thank you very much Ian any further questions Brian microphone please thank you Brian Davis what I just want to mention we are all aware as has been said schools are different the number of staff are different and when somebody does go swimming and go on the bus they need a specific number of staff to go with them that means then if not everybody goes at a number of specific staff need to be left in school so then we come into costs of supply maybe to allow these things to take place that is relevant as well when there are activities happening in school externally the two hours a week they're talking about that's not just a matter of doing the activity it means that obviously you need arrangements etc and safety but it also comes down to the number of staff on the additional cost that comes to a school to achieve these activities it does work quite well with the schools that I have but it does crop up despite that and there's more to it than meets the eye and it's not just putting them into action DIAH thank you if you see on page 31 of the report there are recommendations there and ideas there as to how various options that aren't available to take the pressure of the school but again there is a financial impact there that the cabinet needs to consider but if you look at the bottom of page 31 action option to be so there are ideas there that and the cabinet will be considering whether that could improve the situation and there would be a financial impact of course on the enjoyances activities for example I just want to give a comment we are all within financial restraints you know if money does come in someone else suffers if we get it from someone else so the cost of transport that is something to consider I know that the PTA is responsible with us for that and the majority of schools I think as well but would it be possible to look in the future look into whether there is a surplus available in the department that we could look at supporting the cost of the transport for the PTA and possibly then that could be given back to the school in another way it's just might be wishful thinking but I thought I should mention it I know that everybody recognizes the cost of transport especially in rural areas the cabinet and others will need to consider what is possible but I can't promise more than that Brian. Thank you chair and as a member of the task and finish group I would also like to thank those involved because it has been really useful to get all these reports and get all the information and realize that it is an emergency really for the health of our children in the county we are talking about cost and it is with all the cuts but what has come out to me a parent is the cost on health in the future if we don't tackle the issues that we have seen and following these recommendations I I hope even though there we don't have health responsibility as such there might be a way for us to work alongside in the future if setting this out and hopefully at the end of the day we will look after the health of our children and prevent issues as Councillor Karen mentioned prevent the issues that we are seeing already amongst children and the cost for the health on that so I hope that will be considered also it is an expense it is too much cost too high to pay on the health of our children if we don't look at these recommendations and get them to work we have of course mentioned the challenges for schools but we can possibly look at what every school can face individually but a big thank you to everybody who has contributed to the report it has been comprehensive work it has been a lot of work in a short period of time but thank you very much to all. Are there any other questions if not we will one point at the end on the report but I would like to thank Emma who has pulled all the information together and put every all comments together and put all the report and organize everything and that is not something that I would like to do and it's not an easy task so thank you very much to Emma for all the work in the background and you more than anyone has prepared this report for us made it possible for it to be considered today Brian thank you chair I would like at this point I should have said at the beginning I would like to apologize that I haven't been in attendance in meetings prior and that I haven't given apologies because of illness but I hope that I will be able to contribute in the near future thank you. Do you mind understand that no problem? Any further hands for questions on this so can we ask if someone is prepared to move that this report be received and it now be perceived the cabinet for for cabinet consideration time table for July current Davis and heaven. Thank you so can I ask all those in favor please show your hands and that's unanimous so thank you very much then report is now received. Yeah okay we'll now we'll now move on to agenda item number seven which is the family support strategy and that's on page 99 of the agenda pack where committee has been asked to provide recommendations comments or advice prior to a consideration of the strategy by you cabinet so I can ask so the family support strategy the community family support strategy has been due for review this year it went from 2018 to 2023 and as you'll be aware from the presentations and reports that I've provided on the budget position and the proposed transformation program in children's services the idea of early help is an absolutely key part of that transformation of the way that we managed to manage support families effectively and prevent escalation into high levels of intervention so this paper really is setting out well what is early help then what are the principles why we're moving in that direction and how we know that we're succeeding how we'll know that we're succeeding and the timeframes for this so hopefully this sets it out quite succinctly for you we've got a long-standing commitment during command shirt to supporting families sooner rather than later what the early help approach will do is move people away from an idea of a service so early help as a service or a set of provision and early help as a collaborative approach right across the kind of public and third sector in command and share so that everybody understands their particular part that they play in providing early help in that continuum of support for children families the the principles then are right to help right time in the right way for families that set that set out here it's really important that we we do understand that things have changed the the need within families has changed the need within communities has changed the the level of kind of community support the way that that's organized has changed and our approach needs to change in response to that and we need to get ahead of it as well so that we can effectively provide support into families at the right time in the right way into the future so what the strategy will do is acknowledge those changes many of which you know those those things have been rehearsed already in this form and in other forums it won't be news to any of you those those changes we set it out in the budget work that we did so the strategy will set out the current command and share context for example we know that levels of deprivation of increasing the family support strategy was put in place we need to recognize that technology and make sure that we're responding to that in an effective way so it'll outline the common purpose I think this is really important the the early help strategy will make sure that this is a multi-agency approach creating greater opportunities for partnership and integrated working so what we'll hope to achieve through this approach is a reduced number of children who are subject to statutory social work assessments so you'll recall when I presented to you the way that we'd realign the responsibilities within children family services we have a senior manager responsible for both early help and our front door and assessment teams there's a very clear connection if we get really help right then the families won't come through so readily and being re-referred as well through two-hour statutory assessment teams so we'll we'll seek to reduce the number of children who are subject to statutory assessment reduce the number of children who are closed following that statutory assessment so trying to make sure that the right families come through to assessment so that we've got that that bit of support just before that eligibility for statutory assessment that means that families don't need to come through to assessment because we don't need to assess their needs because they're accessing the support they need the right help at the right time and the right way for them so we'll reduce the number of children coming through open to statutory assessment and then closed we'll reduce the number of children who are subject to care and support plans and our child protection plans reduce the number of children who are looked after so what we're trying to do is that channel shift of support making sure that there's the right support available to families before that statutory assessment and i'm sure that you'll be aware from the work that you do in your communities with families that sometimes family will say we just can't get the right support and what what this will seem to do is is address that so the timeline then is we do we're undertaking the scoping work now in May well now and into May we're engaging with partners you can imagine schools will pay a key part in this and our third sector colleagues as well will be establishing early help hubs and that will be a provision to be a children services provision and the part of the budget growth is an investment in in that means of delivery and then in October we'll be bringing through the early help strategy the implementation plan through to CMT and yeah so that's the that timeline set out hopefully that's kind of a succinct overview of where we are and i'm available for questions thank you very much mean it thank you very much and thanks for the presentation to this report i i have a question are we going to see this strategy as a scrutiny committee sometime in the process and when i would appreciate possibly to get more information to understand the processes and how it will work so in the future so basically will we see this strategy thank you yes absolutely so looking at the timeline it'll be somewhere between the June and the October dates so June is where we'll be really getting our own practice geared up and delivering our own internal services in a different way in law we've done that work with partners and in October is when that'll be being presented to CMT so if it could come to scrutiny somewhere in between those dates i think that would be great yeah because the strategy itself would definitely come to scrutiny as part of the process anyway yeah yeah thanks for that confirmation and we can also consider that now after the meeting when we need to go into more detail um in relation to that information thank you i want to ask ask some of the health partners or is it only social services side no it'll be um education health police partners um so the i'm our third sector partners as well many of whom we fund through the family's first grants um so we fund youth services for example and what this will do will will bring all of that really closely together um into a very strongly connected system so that um schools for example families will know where to go for support rather than having to go to a range of different services they'll come through one set place that nearly help herbal whatever we call it and then the partners within that early health system will be able to say yeah that's one for me i'm a domestic violence expert that one's for me and so we work much more in a connected way we do it already we're building on that good practice we're just responding to the changes and and ramping it up really to give members chance of or digesting that i'll ask ask a question for it um one of the key differences you know between the family support strategy approach that we currently have and the early help approach that you've you've articulated so one of the key differences between between both assuming that you know partnership working and the other principles of getting the help of the right time the right place and the right way i presume would would be a fundamental part of the family support strategy anyway so what are the key differences so i think for me it's building on what we already do but bringing it much more together in a connected ecosystem where people recognize that they're connected so at the minute families will do their own finding schools for example will bring up a range of services to try and get support what this approach will do will in a very structured and coherent way allow partners to be part of that wider system so it's building on the family support and then it's bringing people together in a connected way so it's almost like a phase two i guess it's a building on what we've got and and also some more investment in that that early help as well i mentioned school there yeah that's my um governor as most members are that's my experience as well of school does that mean the hope there will be the initial contact point um for any concerns or whatever or any advice and then things would then be joined up at that very early stage yeah so we'll be working out what those processes are with schools because it'll need to make make sense to schools um but the idea will be that it all comes through one place and then is go this those organizations who will have a sense of being connected will then offer the support the family rather than the the families going out to all of the the provision which i think is better for families just thinking about that early help also probably means for families and children before school age does that include that and they're not just using the schools yes definitely our early years provision will certainly be part of that yeah which is key relevance to obviously what we just debated earlier in it all in all links in and absolutely um the question how how long do you anticipate this take into really embed itself because it's very well i'm in strategy and and and sign up at strategic level a realistic time timeline for really embedded realistically for embedding two years i'd say thank you any see any other hands with that thank you very much and we can look forward to having well the strategy would be on this timeline that you've presented we've received that committee will receive in the strategy anyway after cmt and before proceeding to council would it so that would be any autumn yeah autumn of this year plus of course the quarterly update to regard to progress on the general children services plan of which this is obviously a key a key part so if you could all stretch together with regards to update so if you come out can i ask someone please to propose that the port be be accepted because the philip wallow on mission because of michael tonnehill proposed and second would all members please show the reason you hand if in favor of receiving the report but again it's anonymous and the report is therefore therefore received and it allows us to go on to agenda item eight the final agenda item which is to sign as a correct record the minutes of the last meeting we just held the 21st of march of this year page 103 of the agenda park so we've been asked to approve the correct record of that meeting so i'm prepared to move the minutes be adopted it's an accurate reflection on the meeting and the minutes be adopted can i have some of the mainer proposals can i have a seconder because Alex Evans thank you okay all those in favor of except in the minutes thank you very much so they've been adopted as a correct record and approved thank you the minutes are therefore approved there are no other items on the agenda and the next meeting of committee will be held on the 13th of june this year thank you very much to you all for your attendance this morning for your attendance uh wind that can hour i now declare that the meeting has closed Thank you.
Transcript
Good morning Councillors and welcome to the scrutiny meeting for social care and health. There is no fire alarm to test plan for today so for anybody who is joining from a council building if the alarm should sound it won't be a test and you should follow the appropriate fire exit signs. The meeting, I'd like to remind everyone present that the proceedings of today's meeting are being filmed live and may be kept on the council's internet site as an archive record of the meeting. The images and sound recording will also be used for training purposes within the council. All members should have tested their microphone and IT equipment before the meeting starts and every Councillor who wants to receive simultaneous translation from Welsh to English should click on the interpretation symbol at the bottom of the page and then click English. I take it for granted that translation is working. Changing the meeting via the English language webcast will receive Welsh to English simultaneous translation automatically and 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 coded. Can I ask members and officers present in the meeting today to please introduce yourself before you speak and can I also respectfully request those online to have their cameras on for the duration of the meeting and not just when speaking. Dergavao, thank you very much. So moving on to the agenda itself, apologies for absence. I am aware that Councillor Tremlatt, the cabinet member for health and social services, is unable to be with us today due to health and best wishes for a speedy recovery. Are there any other apologies received? Okay, Councillor Rivene Roberts is trying to join the meeting and hopefully will be able to join us soon. Any other apologies? No? Thank you. Moving on to a agenda item two, declarations of personal interests, could I 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 the interest to be disclosed. You would also need to repeat your declaration of personal interest of 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 am also sorry by members that party whips are not allowed at scrutiny. If there is one in operation, it must be declared, a member subject to the whip will not be allowed to vote on any issue subject to that whip. Members, please raise your hand if you were to declare an interest or if a party whips has been issued in relation to any agenda item before this today. No one, thank you very much, shall we proceed to item three, public questions and I can confirm that no public questions have been received. So we move on to the first substantive item on the agenda, agenda item four, which is the revenue and capital budget monitoring report for 2023, 24 and that is on page five of the agenda park. So committees are asked to receive the budget monitoring report for the health and social services department and services and consider the budgetary position which indicates that as the end of February, there is a revenue overspend or 7 9.7 million pounds, 6.9 million within children services and 2.8 million within adult. Which if you look at the report, it takes the domestic steel cabinet members thunder on this, but if you look at the report, it takes the net expanded forecasted expenditure on social care within CMarthenshire to 144.5 million pounds, with a total expenditure exceeding 200 million for presumably the first time. So at this point, I will now call along the cabinet member for the sources, Councillor Aline Lenny, to present the report to us. Thank you very much, Chair. As you have noted, the spend is significant, of course, on the services, apart from education, this is the biggest. And the forecasted budget, as you said, is an overspend of 9.7 million. Appendix A on page nine shows a summary of the services and the variances from the budget. The forecasted budget overspend on children and family services is an area of significant concern to the corporate budget position. And while recognising this, a working group has investigated the reasons so that the current demand on children and family services can be understood. A transformation programme for children and families has been developed to set out the overall strategy for children and family services to manage future demand, to meet statutory obligations and to achieve a balanced budget. Appendix B shows the most significant revenue variances, followed by the full detail in Appendix C. The projections for the capital budget are on pages 19 to 21, and show a projected underspend of 267,000, which is primarily due to slippage on the Carter of Kinesse development project. The summary for the capital budgets are in Appendix D and the details in Appendix E. Appendix F outlines the progress in delivering the proposed efficiencies for this year. At the moment, 1.4 million is considered to be deliverable with an unmet target of almost 600,000. Thank you, Chair. Thank you very much, Aline. Aline, for that, right, if you're going to ask members if you have any questions you'd like to put to officers or the capital member with regards to the budget, I suggest we go through it. Appendix A to C first, so if you can start on page 9, look through each report, and if you have any questions, please put your hand up. So anything on the summary on page 9, which is, I think the capital member took us through, so moving on to page 10, which gives us some detail there on adult services, physical disability services. Any questions? Please, Chair. Thank you. So, page 10, the notes advise some of the overspending the result of the external staff agency costs and you're developing an in-house agency pilot for the schneshly-based homes. I just wanted to ask how this is progressing. Please, Diyolch. It will be in a position to respond to that, thank you. Sorry, I didn't quite get the end of that question, apologies. There's an overspend and they're developing an in-house agency pilot for the schneshly-based homes to be rolled out in April 24, I was just wondering how it's progressing with the timescale. Because it was saying with a view of successful of deploying it across the county this summer. Diyolch. Thank you, Diyolch. If an officer is present, hopefully, who might know the latest on our efforts there to nurture more of our own staff, of course. I have been part of this pilot and things have been progressing and everything has been set up on aggressive and everything. So we are looking to start that very soon. So by next time, hopefully, we'll be able to give you a better update by next time. Thank you very much. So it has been set up and it's a bit early days to see what the outcome is, but things are moving forward, yes, they are. It's very early days at the moment, so hopefully, we can give a further update. So anything from Appendix A to C will take those appendices first. Any further questions for members? Brian. Good, very good. Thank you, Chair. I just want to ask, maybe explanation has come, but there is -- the reason for the biggest overspend is the agency staff. What happens about that? I'm sure we're trying to employ more internally, but is the figure reducing because there is a lot of overspend on the agencies? Thank you. Good question. Dylan Jones, group accountant. As I've said, it is early days for this pilot, but we -- officers are looking at when we need to get internal workers back from agencies, and we are scrutinising that much more now, and also when the pilot comes in, hopefully, we'll see results coming from that over the next few weeks and months. Thank you. I should have said Councillor Brian Davis. I was just thinking, is there an eagerness from current staff to take on more hours? Is that something that can be considered at all, or is that not possible? To be honest, we would have to look into that and come back to you. We wouldn't be in a position to answer that at the moment. Thank you. Councillor Alex Evans, sorry I didn't see your hand up there, so apologies if we've been kept waiting. No, I haven't been sure. No problem. On page 12, I could ask about the admission residential placements with a forecast overspend currently at another 3.5 million, this is a significant portion of the budget, sorry, the department's overall deficit overall. I understand it was doing really good work as a Councillor in creating in-house capacity going forward due to the extraordinary costs of going through private companies for these placements. The only question I had really is have we actually forecast enough future budget forecasting how much will actually save year on year going forward, so even for the next year or two, by creating this in our capacity that are we actually able to say that based on this capacity we can create a velocity of X amount on this deficit, on this particular item. Thank you. Councillor interjecting. Thank you. Councillor interjecting. At your request. Thank you, Chair, and thanks for the question. It is a concern for us, of course, there are cases which have very complex needs and there are no places in Wales for these young people. We have to provide places in units outside of Wales and it costs about 20,000 a week in one case that we are aware of to look after one individual who does have very complex needs. We are trying to develop a course within the county to provide for a lower level possibly, and it's difficult to say at the moment, and it's hard to know from year to year, really, how much money to keep for this because maybe next year there would be less cases or possibly, you know, if there are one or two fewer cases it might mean £1,000,000 less to find, but one of the officers might be able to answer that in more detail, giving an overview really of that. Thank you, Alan. John Coles, Head of Children and Family Services. So children services is a demand-led service and what's really important is that we have the strategies, the policy framework in place to enable the teams to manage that demand effectively. We've seen the demand since the pandemic change and increase and we set that out for you previously in the budget report for you in some detail. We now have strategies in place to go forward, make arrangements to be able to manage that demand effectively and equip the teams to be able to manage that demand effectively. What is happening though is we have more children here in Kamala Sher who need residential children's home placements than we have had previously and so I think if you go back looking at 15, 20 years over the numbers, what you see is that a dip comes maybe five plus years ago, even ten years ago, I don't have the papers in front of me, I can clarify those numbers specifically but a dip comes so those numbers go down. At the same time we've got a swelling of foster care in numbers which gives us more option and choice for foster carers, for foster care placements. So we were able in Kamala Sher to manage those placements for children, provide them with what they need in a different way, so there was a dip. When that dip came in our use of residential placements, the budget dropped with it, what we didn't do was think, right, there's a dip now but what might come down the future and so what we've got is an overspend where there used to be a budget if that makes sense. So what we're doing, we're doing a number of things in concert. One is we're introducing our really help services which will help us manage, we're increasing capacity in our social work teams which means we can work more effectively with families because we've had this swell of demand in social work teams and we haven't met that with social work capacity. We also then need to increase our foster care placements as well which took a massive slump after the pandemic and then at the very tip of the end here of the spectrum we're developing our residential children's homes. So what I'm fairly certain of as much as I can be is that by doing all of these things together over the next five years we'll see an improvement in that position where we're not going to need to be at the mercy of profit-making providers who can name their price and we're in the enviable position that we have to just meet that price to enable us to meet our duty to those children. We're going to do all of those things together and we will see that improvement over time. This whole strategy is to enable us, to manage demand, to support children and their families and to do it within the budget that the council has set. I'm really hopeful that we're going to be able to do that because I think we've got the right answer to the questions and the challenges that have been posed to us. But more specifics in that, Councillor Alex, I can't give because I do come back to with a man-led service and we could have right now somebody coming through our front door, a family of seven siblings, a family of nine siblings, a family of five siblings, one of whom might need a residential placement and we will have to pay whatever the cost is right now for that. But this strategy that we've put together is going to help us manage that demand on the line. A convoluted answer to something that's a really complex situation, I hope that makes some sense. Yes, it does. With the benefit of hindsight, if we predicted the back to the pandemic, I think we in every year authority and government were invested earlier, but that's the benefit of hindsight. I'll bring Susanna Nolan in here. Well, that's the answer. Susanna Nolan group content for education and children services and Councillor Evans just to clarify as well that within that budget for the 24/25 year, you'll be aware of the significant growth that's been allocated to children services and one of those key areas is around the residential placement, the balance of the immediate need and also then the longer term funding as the new children's homes and new strategies come into place. That's all part of the transformation plan and that's a key area for Jan and the team then to work through that increased budget and identify and review with the actual demand and the services then that will provide that in the most kind of cost effective way as the need to change as well. Yeah. Take a bow. Thank you very much. I assume it ties into our generating seven as well, the other helped strategy to really all fits in. Thank you very much. It comes a current day this week. Yeah, good idea. I'm on the same page, the next one up, the unaccompanied asylum seeker children. Obviously we've got quite a large overspend and my concern is have we reached the maximum of asylum children that we are going to receive? It's an excellent service, but we must be mindful that we're not having, we're having to spend more than the income that we receive from government. So no, we haven't reached the maximum yet. We think given the ratio that's provided to us by the home office, the figures that are provided, we will have around a maximum of 37 children so that's under 18s in our care and a company designed seeking children in our care at any one time. When we reached that number, then that's our maximum. So long as that still remains the correct ratio of the number, the total number of looked after children we have at the time. However, those children are constantly growing older as we all are. So whilst they may be under 18 at the point of referral, within two years, three years, four years, they will become 18, which means that 37 number drops and we need to take another intake in. So that number is moving all the time. The young people are moving through from being children, that under 18 number, which is a maximum of 37, through into over 18s. There is no maximum number of over 18s that we require to support. So the challenge for us is to make sure that we very quickly ramp up those support services so we're not doing the ad hoc spot purchasing of provision for those children, and that's where we are and you'll recall that in the budget setting process and the report that I did last time, one of our priorities is to be developing our services, running company designed seeking children, so that we can deliver that within the home office budget and we're doing that in a variety of ways. Sorry, Alex, I think I'll get you off there. You did have your hand up. Have you? Yeah, sorry, Chair. As well as they thank you to officers, I'm the camera member for the answers. I just wanted to kind of explain as well. I fully appreciate that the demand will dictate the actual size of the office panelist particular item. What I was asking is do we have an idea on average of what, say for example, you know, a home we'd be creating, I can't wait to seven people. If that home was fully occupied, do we have an idea on average, what would actually save us? If they'll save them, how to go into private accommodation instead is what I was more getting at. Do we have an idea on average what each home will save us compared to what it would cost to a private accommodation? If that makes sense. So I appreciate the overall demand. It's impossible to know what the overall number will look like irrespective of how many homes we create. Thank you. No problem. Before you come in, John, that is the business case. Is there of establishing the homes in the first place? Exactly. So that is the business case. So our homes will cost us per head, depending on the number of children. So we'll have different homes that will meet different needs. So we'll have a different number of practitioners supporting children in the different homes. So the unit cost for each home will be slightly different, but it will be certainly cheaper than the costs that we're paying per unit for most of our children at the minute. So we're paying 12,000, 13,000, 14,000, 20,000, 32,000 pounds a week for those various placements that we have. None of our in-house placements will cost anything like that. There'll be around the six and a half, seven thousand pound a week unit cost, depending on how many children are there. We won't be making large institutions. Those days are thankfully, mercifully behind us. So these will be replicating so far as we can a family home environment where children can live with a firm set, consistent group of staff who will be their kind of replica family if you like in those homes. So that's the challenge for the team. We do it with the best value that we can possibly do it. We have got the costings profiled, Councillor. We do have that detail, so that what we know is that we've got plans for young people, so we've got a young person who's in a 12,000 pound a week placement. We know that as soon as we can get Glen Murug up and running, then we'll replace that unit cost. That young person will be moving to Glen Murug and that will have almost that weekly cost. So we've got that profiled into the budget which will enable us to deliver a balanced budget this year. So we've got those things profiled in. There are a number of moving parts in that. At least we've got to get Glen Murug up and running, but we're doing our very best and working with colleagues across the council to do that. Yeah, we've got it profiled in the budget for the next couple of years. Yeah, that's brilliant. Thank you very much. Thank you very much. Before I bring the cabinet member in, my only question would be are you confident of your ability to recruit sufficient numbers of staff? We've been really fortunate these last months. I've had team members, Karen Barlow-Satt here who's been doing this work as well, where we've been wall to wall and end to end week to week interviewing. We've had a really good response. We've recruited to about 80% of the posts that we've advertised for the residential children's homes, which I think is phenomenal, and I think what that does is it shows that we've got something really good that we want to offer. People want to come and work in a place which puts young people's well-being at the heart. We're making no apology for what we're doing is about placing children's needs at the centre of this. So yeah, I'm confident that we'll be able to recruit most of the team that we need. Excellent, thank you, Ali. Very quickly, Chair, looking at the picture nationally, as you know, following the collaboration agreement between Clyde Comrie and the Labour Government in Wales, there is a commitment to delay the private profit from the children who receive care using a not-for-profit model instead. And this, of course, is by starting, of course, by concentrating on care homes for children and foster carers. Thank you. Just to look at the picture in general. Right. So, Anthony, further questions on appendix A to C. We move on to appendix D on page 19, which is the capital launching. Members, have any questions on Capita? I'm sorry, it was a candidate, yes. On appendix E, the purchase of Placer Brin Congulier, this is the first time I've noticed it, could I have an update on how it's proceeding, please? Then it's been led by Alex Williams, who's leading the Pentra-Awell program as well as head of service. We have a working group, we are consulting with English counties to examine how they've proceeded with the development of a local authority care home, because it'll be the first one in Wales if we do proceed with looking at nursing care being provided as well. So, we're looking at different models to ensure that it's workable and looking to see if we can see different strategies of how they've been set up, but the idea is that we will look at providing nursing care from that home as well. So, there will be an extension built on it and obviously a refurbishment of the current home and it's in the early stages, but we're looking to see whether we go as far as providing nursing care as well in that home. So, we're looking at different models really across different areas, and if we do proceed, it'll be the first one in Wales to provide nursing care, but, you know, the local authority can do that. Thank you for that, just as a local member, I know about the purchase, but I haven't been informed of any further development, so of course people know that it's been sold and I am starting to have questions so it would be if possible kept in the loop as regards any further information. Yes, of course. It is in the very early stages of looking at what exactly will be there, but it will be obviously a care home providing dementia care, residential care, and possibly nursing care. Okay, but I'll make an up to that. Thank you. So, I take it and once the details are finalised, there's a lot of, obviously, discussion between health, look at the situation, which, you know, cells and health and lots of other issues as well, but once we have a detailed programme and a timeline that the local member of the province, you will be, will be informed. Yes, we'll definitely. And I will speak to Alex to make sure you're kept. Thank you and thanks for the answer, and thanks for the question, Karen, as well, and it is important that local people know exactly what's going to happen here. As we've heard the plan itself hasn't been completed yet, we did buy the home, which went for sale, because as you know, it was closed by the company that was in ownership before that, and we were happy to approve that purchase, but it is important that local people know exactly what is going on, and as a cabinet member responsible for assets, I will work with the officers to make sure that the information as much as we know is distributed. Thank you. Thank you very much for that promise. Okay, Karen. Thank you. If you further questions on those appendices, we move on to Appendix F on page 23, the savings boundary report. Any members, any questions on that? If not, this then Appendix F, as well as gives the detail. So if I allow no further questions, can I thank everyone for their questions and for the officers for their input, and can I ask you, is it so prepared to move the report be received? Because the current Davis, and can I ask for a second there? I think it just comes to the Phillip Wallo, and seconding, all those in favour, please raise your hands, and that is unanimous. Thank you very much. So the report is received. I will now move on to agenda item five, which is the domestic recovery care performance update. In the context, in January 2003 committee requested a regular performance update regarding domestic recovery care provision within the county. The report in front of us is the fourth report to be provided, and I understand that Jane Thomas, the senior delivery manager for long-term care, will present the main issues within the report, and then I'll invite members to ask questions. So if that's okay with everybody, Jane can ask you if you introduce the report, thank you very much. The report provides a key data relating to the number of hours commissioned by Dom Silly Care. The number of hours waiting for Dom Silly Care, and the number of people waiting in the community for Dom Silly Care, and the number of people waiting in hospital for Dom Silly Care. The in-house Dom Silly Care versus the external providers, you know, the report covers the continued recruitment and retention challenges with regards to home care, however following a robust and sustained recruitment program in January 24, we've seen an increase in the number of applications to our home care posts within the local authority trend which has continued throughout quarter four, we're also seeing an increase in the number of overseas worker applying for posts by sponsorship, which we have not been able to support, but the conversion rates from application to appointment remain lower than we would have hoped for, but we are working with that. The services focusing on strategies to promote expansion of the in-house services and recruitment and retention challenges have been having an impact, but this is obviously the same across Wales and the UK, it's not just for commercial, and at the moment we're currently providing 37% in-house, but we aim to get up to 50% of the market. And we are promoting, we're focusing strategies on that promotion and expansion, but the recruitment and retention, we are focusing on that and we've got an active campaign going forward to continue the progress we've made in quarter four. So for mitigating the risks for the weightiness, there's still an interest to manage the risk, and we are therefore continuing to review those waiting for care to ensure the needs have not changed and people remain safe throughout regular, by regularly keeping in touch, and we've appointed for what we call care and support coordinators. So anybody waiting for care will be allocated to care and support coordinator, and they are contacting anybody waiting for care every seven to ten days to check that their needs remain the same, and they still manage it without care unless the person themselves, as some people say, I really don't want to call every seven to ten days, you know, can you ring me once a month, or can you ring me when the care is available for me to receive? But that gives us assurance that people are not waiting and we don't know if they need to change it, if that makes sense. We'll also continue in with our release in time to care methodology, which to actively reduce the care packages we're appropriate, and release hours to support others. So that team focuses on our double-handed care calls, and the occupational therapists review and ensure that there's appropriate equipment, and we may be able to reduce those care packages from two carers to one carer. It's working very well, people find it very positive, people have less intrusive care, because they're only having one carer coming in and they send two carers, and they find that their independence is promoted, and that is working very well, and we do reduce the care packages in that way. We have a fortnightly meeting that takes place to review the long hospital weights. This allows us to challenge and review and ensure that all options being considered. This has had a considerable impact on reducing the hours with those waiting in hospital and in addition, there are twice weekly hospital escalation panels where all difficult cases are escalated for discussion. We also offer the Delta Connect and direct payments to both the person needing the care and also to the carer, who is providing the care to support them whilst they're waiting, and to support the carers with their own needs whilst they are caring for someone who is waiting for care. And everything I've just mentioned is helping us to manage the risk of those waiting on our wait to list. Do you have any questions? Thank you very much, and to inform committee, you've stepped in a very short notice really got further, A, the cabinet member, and B, do you want to join us as well? So thank you for attending a very short notice, Jay, thank you for the report. So correct me if I'm wrong before I invite questions. So what you've outlined there in the report is that in terms of all the key indicators, everything actually has shows an improvement and that's the key indicators being the number of hours commissioned, the numbers of people waiting in terms of people and the hours involved. And of course, critically as well, those waiting in the hospital for our facility care. Yes. And there are the big headlines that you've reported to us. There's also been a significant decrease in the numbers waiting for social work assessments, which is also a huge positive. But with all those positives, there are, even though there are less people waiting for care, and the number of hours have decreased, there is still a significant amount of people of unmet need then that you need to monitor to ensure that they're in a safe environment prior to the services being provided. Yes. Is that a fair summary of what you just outlined? It is a very good summary, yes. Thank you. Yeah. Thank you. So with that, I remember, first of all, Minaire. Councillor Mayner, James, representing Langen Dayan Ward. I just want to ask a question that you raised in your presentation there on page 38 at the bottom of that page about foreign workers. We are unable to support them. Can you just possibly explain what that means? I'm not quite sure why we're not able to support them and what does it actually mean? I'd have to speak to the Domiciliary Care Manager Julie Tekken and ask her to respond to you because I don't. I wouldn't want to say something because she manages all of the recruitment of the Domiciliary Care Workers, would that be a right if I could do that and ask her to feed directly back? Yes, that's fine. No problem. That's fine. Have you a supplementary measure on the O'Nanyal? No, that's fine. We can see then from having an explanation what it does mean and why we're unable to support them. Maybe another question will arise from that, but I appreciate that we do need to get the right information. Thank you. In the range for all the manual response. Have it. Thanks, Chair. The questions that I have are on page 39 mainly. It's pleasing to hear about the increase in the applications for post-up to the end of financial year, it's good that the focus is on the strategy to increase to answer 50% of the demand in the market and to develop resilience in the system. We are talking about a robust approach to sickness management. Can you possibly explain a bit more about what that robust approach means? Thank you, James, for the question that's about to explain what does a robust approach to sickness management actually mean in practice? I do feel that, again, I'd like to refer to Julie Degan because I don't manage the home carers, the dormitory carers, and I, again, would like you to have a full response. I can talk about our well-being services and our employee support meetings and our occupation and health support, but I really would rather it came from the direct senior manager, if that's OK. Yeah, yeah, Amanda, you're going to take. Yeah, that's fair enough. So we are talking then. In productivity, due to a cost effectiveness, in relation to that increase in productivity, would you be able to sort of give us a few examples of what that might entail and really what's the journey been so far in what we've tried to strive for? So we're developing the home-first base, home-first model care, and we've got different pillars within that home base. So we've got the community assessment service, we've got the re-agreement service, and we've got the release in time-to-care service, which I've already discussed. But with the re-agreement service, we're looking at flow from hospital or prevention of hospital vision or people who have are new to Don Cerique, so they've had a sudden functional change, and we're trying to develop a flow through the system by using rehabilitation strategies with people. So they stay within the service for up to six weeks, or longer, if we can see progress is being made, but the aim is that people are given the confidence to promote their independence to maintain their own care, and then we can support somebody else then, and people might stay in the service for two or three weeks because they're given that confidence and independence. So we try to create flow through the re-agreement process, and then we've got the community assessment service, which is similar, but that's provided by the private sector, and again, they have an ongoing assessment for six, six weeks with a multidisciplinary approach around them, weekly meetings so that we can be productive in supporting people to gain their confidence and not become dependent on caring the long term, but obviously if they do, we then put a long term package in, and that's what the six weeks assessment process is. Yeah, thank you, I'm glad that you mentioned that, if the care is needed, because from the point of view of seeing a close family member sort of rely heavily on domestic care, I very much feel that it's got to be a service who's a led approach, so I'm glad to receive the assurance that it's not rushed in any way, that it's tailored to meet the needs, and continues to meet the needs, I'm grateful for that. In relation to the reference to direct payments made to service users or providers of care, I'm not sure if you could answer this now, but is there an estimate of how many such cases are there, and what proportion of those are actually just actively waiting for care packages to be provided, i.e. being looked after by a family member, etc. I don't know the exact number, and I wouldn't, I could guess, but I don't want to guess, because of the arena we're in, I'd rather get the, I have an idea, but I'd rather get the proper number, and bring it back to the next meeting, or feedback to you directly, but direct payments is processed straight away, so within the local authority, there's a team that manage the direct payments, and the people who manage that actively start to look for PA's personal assistance for that person straight away, so we don't have many people who wait long, because the majority of people will know somebody who they want to employ as a PA, so once we've identified the need, and they decide that they want to proceed with the direct payments, it's, it's usually a family member, or somebody living in their local community, and we can proceed straight away with, um, um, employee in that person going through the recruitment checks, because, uh, DP, uh, direct payments is, uh, is sort of, um, owned by the person themselves, uh, a lot of people will start employing that person at risk, because they're trying to do so, and we will back date, um, the payment, once we've had all the recruitment checks in, but it's because the person themselves is the employee, you know, so, um, is the employer, so they, they can take that risk if they so wish, um, but we do, we do monitor that very carefully, and we do discourage it, but sometimes they're employing a family member, and they know that a DBS check is going to come back here, and, and so forth, and sometimes they're employing a family member, where they, they know there is something on their DBS check, and we will, the social workers will discuss that with the people, um, but there isn't a long delay with direct payments if the person, um, knows somebody who wants to be employed, they want to imply, you know. Thank you, Jane. I think the question is so much for clarity of the question, if the truth is of his manager, I don't think it was so much, like we have in much of delay in direct payments, very ensuring that people have facilitated to, to employ a PA, you know, as a matter of course, it's a matter of how many people are waiting for domestic health care, for instance, and employ a PA, whilst waiting, so the question, how many people have resorted to utilising direct payments because they're waiting for, okay, workers, that was, yes, as other questions. Yes, sorry, I don't know the figure off the top of my head, because obviously that's an ongoing, um, process, but usually when people have accepted the direct payment as, as a waiting for Dom Sariq, they've actually kept the direct payment because it's worked well for them, so, and they haven't reverted back, but I, it isn't a figure I think we've kept to be honest about how many people have, you know, because this, this process we've got in place has been, been in place now for at least two years, or since we've started given direct payments as an interim, so, um, I don't think that's something we've kept, but I could speak to our commission team to see if they can. Yeah, it'd be, it's interesting to know how many basically we're going to play, how many use direct payments as, uh, as an interim, uh, uh, before it was, it was, it was, it may, those who continue with direct payments have made their choice, we take the point, um, how many do we do with our temporary support. I'm grateful for the detailed response that you gave, and that's been insightful in itself in terms of understanding the process and the way people decide to approach it and retain it. But I think I really would be keen to have an insight into whether people are using it as a stock cap, if you will, while they wait for them to look at, because, you know, not, not everyone are fortunate enough to be in a position that they have friends or families who can commit to a long term, um, commitment to caring. So sometimes, I'd imagine that it is a stock cap, um, um, and it'd be nice to see how that fits into the bigger jigsaw. Thank you. Thank you. We'll see you in the, in the, in the panel, sorry, sorry, Kevin, uh, yeah, the, the, Kelvin Barlu senior manager for children services and adult social care, uh, in relation to the previous question around direct payments, I'd suggest, I know there's a, uh, similar question in the previous session, um, from, from the members, one suggests perhaps that in a future meeting, we bring a detailed report in relation to direct payments across the different groups and, and how many, um, are in receipt for what type of support. I think I'll probably answer your, your question. Yeah. And immediately following this meeting, we have committee have a, have a, um, we, we've discussed, you know, for the work plan, which include development sessions that could well be a subject area that members may, may decide that they need further, further information order deeper dive on, so thank you for, for, for volunteering that. Thank you very much, uh, you may not do it again. Moving on, I don't see any other, any other hand, so, uh, is anyone prepared to move that the report, uh, as presented by, by Jane be received? And then he's second out. So I would all members be sure to breathe in your hands that you're in favor of receiving the report, all hands up, can upset you unanimous. So the, um, report has been, uh, has been, we've been received there, allowed, and thank you very much for, for the report, Jane. So moving on, we now move on to agenda item six, which is the task and finish group, um, report entitled an active and healthy, healthy start. So if I can give, um, a brief introduction, detection to this, you have the report in, I'll just tell you the report, I'll just tell you the report in front of you, um, and it's all stems from the publication of some really alarming data indicating that Kamar Dinsha had the highest levels of overweight children in Wales. And committee, as a result of that, decided in July 2023 to establish a task and finish group, which comprised of seven committee members to research and make recommendations as to what realistically could be undertaken directly within and by the authority to begin to address this huge issue. So over the period, there were nine actually meetings have taken place and the findings and recommendations, uh, are before you within the report. And as a member, uh, and a chair of the group, I would like to personally thank each and every member and every officer for your work over this extended period of time and producing such a detailed and substantial report, uh, with an extensive range of, of recommendations and actions worthy of serious consideration by cabinet for action. So thank you all, officers and members for your input, um, and your work has culminated as you can see in the report in seven key recommendations with 37 sub-actions. Again, before we actually discuss the report, uh, particular things have to go, and appreciation have to go to the professional, um, those professionals, um, um, individuals from outside organizations and authorities mentioned on page eight that are all mentioned there. The evidence that those people gave, uh, and the research that they actually presented to the task of finished group was sobering to say, to say the least. And to summarize the, the report itself, um, as I alluded to earlier, um, how well they are at 29.2% as the highest proportion of overweight and obese children age four to five in Wales, with commodities being the highest of those three counties at 31.4% or four to five year old children's. Uh, and those figures are extremely stark. Um, we've got to emphasize, um, it's not as easy as, as telling people, uh, to eat the balance diet and to exercise. Uh, I'm told there are nearly a hundred reasons and factors at play that actually have an influence, uh, and actually directly on, on obesity, and that ranges from medical conditions to medications to a whole range of, in, in many cases, interrelated issue. So it's not a matter of one or the other or both is far more complicated than that. The scale of the challenge, however, um, from the research, um, highlighted by the task of finished group, um, it's highlighted within our own data here in Kamar, uh, and the report is focused on what can we do as an authority, um, with regards to this subject matter. There are big issues here with, obviously, at the process, food and food labeling, which are governmental issues, so it'll be very easy to actually, um, put the focus on there, but there's nothing that, uh, directly we can do, so this report, as I'm sure you've noticed in the recommendations and subactions are all within the authorities, um, remit. But the scale is huge, so for instance, how many of us were aware that 87% of, of, uh, pre-school children, uh, uh, are below average or poor in their motor competencies. And I, I wasn't fully aware what motor competencies actually were until I was on this group. It means running, jumping, throwing, catching, or balances, all things that we take for granted our children can actually undertake, naturally, but that's not the case. And that's been measured by, uh, a validated motor assessment tool. So that predicts, that, that predicts high inactivity levels, and that does a direct link then of risk of poor health trajectory in adulthood. Likewise, less than half of our 73, 73 schools, um, that were surveyed, comply with the recommended two hours of minimum time for physical education, with 23 offering 60 minutes or less. And on similar themes, school swimming attendees have almost halved over the decade for nearly 80% to pupils to 34.8%. But on a real positive, the group have been really, really impressed by the number of projects and initiatives that already been undertaken locally, when we're in the county, to address these, uh, issues, uh, and the survey recommendations there to say is imperative that all those initiatives already been undertaken, uh, carry on. The threat, however, is in the fact that most of those are dependent on short-term funding. What used to be European funding and now more recently SPF funding, which all have relatively short timelines and implication that has for, for instance, the Conquenbreath Project, youth services very heavily on, on grant funding and the risks associated if, um, if what funding were withdrawn. So, as I said, I'm done to summarize, this is an extremely complex subject matter, um, and it requires a totally holistic and strategic and operational multi-agency alignment of everything that is, uh, air, everything has been done at the moment, and be linking into emerging strategies, you know, the big hit does being the new prevention strategy, which is currently at early stages of development, the maternity and early years strategy for West Wales, and our own local food strategy. All those are key strategies which must interline, not only strategically, but operationally, to allow what's currently been undertaken to both be grow and, uh, actually, make best use of resources and produce far better incomes. So as I say, the report makes some key recommendations, and they are around stakeholder governance, which is bringing everything together, the considering of prenatal and preschool age, which is absolutely vital, primary schools, the community sport, the school swimming provision, food health eating, and addressing inequity, which is currently within the county, because some areas have very successful pilots, what other areas both have that provision. Some areas have ample play areas and playgrounds and et cetera, community sporting facilities that they don't, and it's suggested that we use the opportunity to penetrate our wellness out to naturally bring us, to concentrate, particularly on the most pride area in the county, and to use the advantages and the opportunities that we will bring on this agenda, and finally, effort for future infrastructure, to enable children and families to actually be active. So a day of hour, we have similar to the report, so now over to the members for any questions. Take a moment. Carla. Yeah, could I read this isn't a question. This is a compliment to those as I wasn't on the committee. So I can quite easily say this, that what has come out of this report throughout from the committee is outstanding. As a pharmacist, I see the children pre-school and primary school age who are actually struggling through ill health because of inactivity, and I really do hope the cabinet will back this because it is something that we can do throughout our communities. So well done, everybody, who took part. Carla. And you're the members. I'd like to comment or raise any issue on here before I ask the officer this. Ian. Ian George has a leisureist here, and he had one of those, I've thanked in the report generally there, had a massive input into this along with other officers from your sections of the area, have it, or the other one, shall we? Do you want to go first or no? I'm pleased that the chair has mentioned thanks to the officers because as one who was part of the process, it was an education and it was a pleasure to be part of the process as well. I'm pleased that the chair has talked about the operational side of putting these recommendations into action, and that can help with some of the concerns which would come in the future. The chair did refer to equity, and I feel that there are some things in the current financial climate which are threatening that equity. And one concern I have is relevant to recommendation three, where it talks about what happens specifically in primary schools. We all know as part of the consultation on the budget that was last time, there was talk about various things that are discussed in the education sector about the possibility of a cut in relation to the budget per head, per pupil. I think in the context of equity, that is a real threat because not every primary school isn't in the same position in relation to their capacity to face a cut per head for the pupils and don't have the same capacity in being able to provide what is in the recommendations when they are facing such cuts. So is it a time for us to consider if there will be a cut? Is it a time for us to consider various situations of schools, what resources they have, what opportunities they have locally, instead of that happening across the county on a flat level, if you like. In the context of the recommendations in this report, are we looking at a position of schools individually, the size of the schools, the type of the school? So in order to put these recommendations into action, I think we as an authority be ready with the schools, thank you. Yes, that is a fair question. It's probably not for us in scrutiny to actually do this, there are implications for all these recommendations. What I should have said and something very important, I didn't actually say in the summary, is that the committee have deliberately operated within the context, so assuming that there is no extra money. So even though there is 37 sub-duction, all these recommendations sub-actions, it's all in the context of the financial reality that we are in at the moment. So rarely this does not ask for a company to invest half a million pounds in this initiative. It does ask for is, could you please consider these recommendations of how we can actually undertake this, here has been undertaken at the moment, we treat what our policies are at the moment because the council have a defined policy on swimming, for instance, and at every child at the age of 11 should be able to swim, I forget the length now, but that policy was confirmed comparatively recently. We've got the figures here to say, well, the numbers actually achieve enough are falling. We've also got the data of activity levels generally, even though it's accepted a prevention exercise is probably one of the best prevention, preventive options you can take to secure your health. So in fact, there are other activity levels, physical activity levels, permitting, be that in sport or across the board. So come up to your direct question, yes, there are recommendations here which have implications both operationally and financially on education in schools. What you mentioned is very apparent and that is what obviously cabinet will have to take into account on the wider issue really of how much of this, should it be, these recommendations be adopted, what are the implications operationally for each and every school because not every school is in the same situation. But what I've been very impressed with and that's not just a leisure department more than anything, is the immense amount of data that we already have between leisure education of activity levels in school. There's a wealth of information out there, some of which is in the report with regards to participation in certain activities, some schools participate. Proactively, other schools don't and there's a whole, it's one of the recommendations. There's a whole raft of work and need to be undertaken really is to understand our current position, understand the implications of it and work through basically and I think I'll bring you in here, you'll have to work through school by school basis and then is it doable, isn't it? And if it isn't, why, long windy answer to say yes, these are things that cabinet will have to get the grips with and be satisfied on why, when they consider this report which I think is in July, I think timetable for July, yes, yes, I completely agree. The pressure I think that would equities important, if we are going to make sure of that we can't take an approach of one size fits all, we have to and the cabinet will have to look at the size, the location, situation of every school individually and I think it's important that this work does happen, sorry Ian, to put you on the spot, do you want to add anything further, something I possibly haven't mentioned in the summary or respond to having anyway. Yes, one of the things in relation to equity is the inconsistency that we saw and it's not just relevant to schools, it happens in other places before children reach school, before they reach school like nurseries, etc. So there's obviously an inconsistency and I don't know that, whether that's demographics of the area, sometimes in relation to schools, it's because of the size of the school or how the school is managed, who their teacher is, you know, there are many aspects that do influence it, but there is obviously inconsistency and what we are saying in the report is that the work that we want to do specifically with the education department in school is to try and make sure that they do sign up really to these recommendations and say that every school needs to provide those opportunities regularly because obviously some children are missing out and some are not, some schools bring them swimming, some don't do activities after school, some do two hours of PE. I think it's one of those basic things really in the agenda for the county, this might sound, but when you talk about the well-being of future generations, well basically this is it, and one of the other statistics in the report is that it is four times more difficult to change a pattern of how people behave by the time they are in year four compared to when they're four years old, so that's, you know, four years old, up to eight years old, you know, it's four times more difficult to change behavior in that very short period of time, so we have to try and do something as early as we can in their lives and do that on a regular basis, so that was one thing that did stand out for me, and as you said, Gareth as chair, we have tried to write this understanding that there is no additional money, unfortunately from us as a county and know the other sectors, but what does happen is that there is a lot of good work, excellent work really, the concern with that is if that work didn't happen, where would we be now, and how worse off would we be, but obviously there are opportunities to work better together, and I think we need to approach that there are pockets of good work happening over the county in various areas, different sectors, but I think with better governance hopefully we'll be able to do that on a more consistent basis, and get the best out of the resources that we do have, be it staff, provision, facilities, etc, that we try and do the best of what we have. Thank you very much, Ian. Any further questions, Brian? Microphone, please. Thank you, Brian Davis. What I just want to mention, we are all aware, as has been said, schools are different, the number of staff are different, and when somebody does go swimming and go on the bus, they need a specific number of staff to go with them, that means then if not everybody goes, a number of specific staff need to be left in school, so then we come into costs of supply maybe to allow these things to take place. That is relevant as well. When there are activities happening in school, externally, the two hours a week they're talking about, that's not just a matter of doing the activity, it means that obviously you need arrangements, etc, and safety, but it also comes down to the number of staff and the additional costs that comes to a school to achieve these activities. It does work quite well with the schools that I have, but it does crop up despite that, and there's more to it than meets the eye, and it's not just putting them into action. Thank you. If you see on page 31 of the report, there are recommendations there and ideas there as to how various options that are not available to take the pressure of the school, but again there is a financial impact there that the cabinet needs to consider, and if you look at the bottom of page 31, action option 2B. So there are ideas there, and the cabinet will be considering whether that could improve the situation, and there would be a financial impact of course, on the enjoyances activities for example. I just want to give a comment. We are all within financial restraints, you know, if money does come in, someone else suffers if we get it from someone else, so the cost of transport, is something to consider. I know that the PTA is responsible with us for that, and the majority of schools I think as well. But would it be possible to look in the future, look into whether there is a surplus available in the department that we could look at supporting the cost of the transport for the PTA, and possibly then that could be given back to the school in another way. This just might be wishful thinking, but I thought I should mention it. I know that everybody recognises the cost of transport, especially in rural areas. The cabinet and others will need to consider what is possible, but I can't promise more than that, Brian. Thank you, Chair, and as a member of the task and finish group, I would also like to thank those involved, because it has been really useful to get all these reports and get all the information and realise that it is an emergency really for the health of our children in the county. We are talking about cost, and it is with all the cuts. But what has come out to me apparent is the cost on health in the future if we don't tackle the issues that we have seen. Following these recommendations, I hope even though we don't have health responsibility as such, there might be a way for us to work alongside in the future if setting this out. Hopefully at the end of the day we will look after the health of our children and prevent issues. As Councillor Cairn mentioned, prevent the issues that we are seeing already amongst children and the cost for the health on that. So I hope that will be considered also. It is an expense. It is too much cost too high to pay on the health of our children. If we don't look at these recommendations and get them to work, we have of course mentioned the challenges for schools, but we could possibly look at what every school can face individually. But a big thank you to everybody who has contributed to the report. It has been a comprehensive work. It has been a lot of work in a short period of time, but thank you very much to all. Are there any other questions? If not, we will, one point at the end on the report, but I would like to thank Emma, who has pulled all the information together and put all comments together and put all the report and organise everything. And that is not something that I would like to do and it is not an easy task. So thank you very much to Emma for all the work in the background. And you more than anyone has prepared this report for us, made it possible for it to be considered today, Brian. Thank you, Chair. I would like at this point, I should have said at the beginning, I would like to apologise that I haven't been in attendance in meetings prior and that I haven't given apologies because of illness, but I hope that I will be able to contribute in the near future. Thank you. Brian, understand that? No problem. Any further questions on this? Can we ask if someone is prepared to move that this report be received and it now be perceived the cabinet for cabinet consideration time table for July, Karen Davis and Heaven. Thank you. So can I ask all those in favour? Please show your hands. And that's unanimous. So thank you very much. The report is now received. We will now move on to agenda item number seven, which is the family support strategy and that's on page 99 of the agenda pack where committee has been asked to provide recommendations, comments or advice prior to a consideration of the strategy by cabinet. So can I ask? Thank you. So the family support strategy, the community support strategy has been due for review this year. It went from 2018 to 2023. And as you will be aware from the presentations and reports that I have provided on the budget position and the proposed transformation program in children services. The idea of early help is an absolutely key part of that transformation of the way that we manage to manage support families effectively and prevent escalation into high levels of intervention. So this paper really is setting out, well what is early help then? What are the principles? Why are we moving in that direction and how we will know that we are succeeding and the time frames for this? So hopefully this sets it out quite succinctly for you. We have a long-standing commitment during the command shirt to support families sooner rather than later. What the early help approach will do is move people away from an idea of a service so early help as a service or a set of provision and early help as a collaborative approach right across the kind of public and third sector in command and share so that everybody understands their particular part that they play in providing early help in that continuum of support for children families. The principles then are right to help right time in the right way for families. That's set out here. It's really important that we do understand that things have changed, the need within families has changed, the need within communities has changed, the level of kind of community support, the way that that's organised has changed and our approach needs to change in response to that and we need to get ahead of it as well so that we can effectively provide support into families at the right time, in the right way, into the future. So what the strategy will do is acknowledge those changes, many of which you know those things have been rehearsed already in this forum and in other forums, it won't be news to any of you, those changes we set it out in the budget work that we did. So the strategy will set out the current command and share context. For example, we know that levels of deprivation of increase since the family support strategy was put in place, we need to recognise that, acknowledge it and make sure that we're responding to that in an effective way. So in the outline, the common purpose, I think this is really important, the early health strategy will make sure that this is a multi-agency approach creating greater opportunities for partnership and integrated working. So what we'll help to achieve through this approach is a reduced number of children who are subject to statutory social work assessments, so you'll recall when I presented to you the way that we'd realigned the responsibilities within children and family services, we have a senior manager responsible for both early help and our front door and assessment teams. There's a very clear connection. If we get early help right, then the families won't come through so readily and being re-referred as well through to our statutory assessment teams. So we'll seek to reduce the number of children who are subject to statutory assessment, reduce the number of children who are closed following that statutory assessment, so trying to make sure that the right families come through to assessment, so that we've got that bit of support just before that eligibility for statutory assessment that means that families don't need to come through to assessment because we don't need to assess their needs because they're accessing the support they need, the right help at the right time and the right way for them. So we'll reduce the number of children coming through open to statutory assessment and then closed. We'll reduce the number of children who are subject to care and support plans and our child protection plans reduce the number of children who are looked after. So what we're trying to do is that channel shift of support, making sure that there's the right support available to families before that statutory assessment and I'm sure that you'll be aware from the work that you do in your communities with families that sometimes family will say we just can't get the right support and what this will seek to do is address that. So the timeline then is we're undertaking the scoping work now. In May, well now and into May, we're engaging with partners. You can imagine schools will pay a key part in this and our third sector colleagues as well. We'll be establishing early help hubs and that will be a provision, it will be a children's services provision and the part of the budget growth is an investment in that means of delivery. And then in October, we'll be bringing through the early help strategy and the implementation plan through to CMT. So that's the timeline set out. Hopefully that's kind of a succinct overview of where we are and I'm available for questions. Thank you very much. Thank you very much and thanks for the presentation to this report. I have a question. Are we going to see this strategy as a scrutiny committee sometime in the process and when I would appreciate possibly to get more information to understand the processes and how it will work. So in the future, so basically will we see this strategy? Thank you. Yes, absolutely. So looking at the timeline, it'll be somewhere between the June and the October dates. So June is where we'll be really getting our own practice geared up and delivering our own internal services in a different way. We've done that work with partners and then October is when that'll be being presented to CMT. So if it could come to scrutiny somewhere in between those dates, I think that would be great. Yeah, because the strategy yourself would definitely come to scrutiny as part of the process anyway. Yeah. Thanks for that confirmation and we can also consider that now after the meeting when we need to go into more detail in addition to that information. Thank you. I want to ask some of the health partners or is it only social services side? No, it'll be education, health, police partners and our third sector partners as well. Many of whom we fund through the family's first grants. So we fund youth services, for example. And what this will do will bring all of that really closely together into a very strongly connected system so that schools, for example, families will know where to go for support rather than having to go to a range of different services. They'll come through one set place that really help her or whatever we call it. And then the partners within that early health system will be able to say, yeah, that's one for me. I'm a domestic violence expert. That one's for me. And so we work much more in a connected way. We do it already with building on that good practice. We're just responding to the changes and ramping it up really. To give members a chance of suggesting that, I'll ask a question for you. One of the key differences between the family support strategy approach that we currently have and the early health approach that you have addicted in. So one of the key differences between both assuming that, you know, partnership working and the principles of getting the help of the right time, the right place, and the right way, I presume would be a fundamental part of the family support strategy anyway. So what are the key differences? So I think for me, it's building on what we already do, but bringing it much more together in a connected ecosystem where people recognise that they're connected. So at the minute families will do their own finding. Schools, for example, will bring up a range of services to try and get support. What this approach will do will, in a very structured and coherent way, allow partners to be part of that wider system. So it's building on the family support and then it's bringing people together in a connected way. So it's almost like a phase two, I guess. It's building on what we've got and also some more investment in that early help as well. I mentioned school there, yeah, that's my governor, as most members are, that makes me this as well of school. Does that mean the hope there will be the initial contact point for any concerns or whatever or any advice and then things would then be joined up at that very early stage? Yeah, so we'll be working out what those processes are with schools because it'll need to make sense to schools. But the idea will be that it all comes through one place and then it goes, those organisations who will have a sense of being connected will then offer the support, the family, rather than the families going out to all of the provision, which I think is better for families. Thank you very much, Meenir. Dioff, it's Madeline Henry. Just thinking about that, early help also probably means for families and children before school age. Does that include that and then not just using the schools? Yes, definitely. Our early years provision will certainly be part of that, yeah. Which is key relevance to what we just debated earlier, all links in, absolutely. The question, how long do you anticipate this taking to really embed itself? Because it's very well having a strategy and sign up at the strategic level, a realistic timeline for really embedding. Realistically for embedding two years, I'd say. Thank you. Thank you very much, and we can look forward to having, well, the strategy will be on this timeline that you've presented. Committee will be receiving a strategy anyway after the CMT and before proceeding to come. So that will be in the ultimate of this year. Plus, of course, the quality updates with regards to progress on the general children's services plan, which this is obviously a key part. So it all frets together with regards to updates. So if you come out, can I ask someone please to propose that the report be accepted, because the Phillip Warlow on because of Michelle Donahue, proposed. And second, would all members please show the reason you hand if in favor of receiving the report? But again, it's anonymous. And the report is therefore received. And it allows us to go on to agenda item eight, the final agenda item, which is the sign as a correct record in minutes of the last meeting, which is held on the 21st of March of this year, page 103 of the agenda pack. So we've been asked to approve the correct record of that meeting. So I'm prepared to move the minutes be adopted. There's an accurate reflection on the meeting and the minutes be adopted. Can I have some other mainer proposals? Can I have a seconder? Because Alex Evans, thank you. Okay, all those in favor of except in the minutes. Thank you very much. So they've been adopted as a correct record and approved. Thank you. The minutes are therefore approved. There are no other items on the agenda. And the next meeting of committee will be held on the 13th of June this year. So thank you very much to you all for your attendance this morning. For your attendance. I now declare that the meeting has closed. Thank you.
Summary
The council meeting focused on scrutinizing the social care and health sectors, particularly budget monitoring and strategies to combat childhood obesity. Key discussions included budget overruns in social services, a new family support strategy, and a task force report on healthy lifestyles for children.
Budget Monitoring Report for 2023/24:
- Decision: The report was received unanimously.
- Discussion: Concerns were raised about the £9.7 million overspend, particularly in children's services. Strategies to manage agency costs and improve in-house staffing were discussed.
- Implications: The council is focusing on internal workforce development and scrutinizing external agency use to control costs.
Family Support Strategy:
- Decision: The strategy was discussed with a view to future approval.
- Discussion: The strategy aims to provide early help to families to prevent escalation into statutory services. It involves multi-agency collaboration.
- Implications: If successfully implemented, this could reduce the number of children needing statutory assessments and care, potentially easing the financial and operational burden on social services.
Task and Finish Group Report on Childhood Obesity:
- Decision: The report was received and will be considered by the cabinet.
- Discussion: The report highlighted alarming rates of childhood obesity and proposed a holistic approach involving schools, community programs, and infrastructure improvements.
- Implications: Adoption of these recommendations could lead to long-term health benefits and reduced healthcare costs, though it requires alignment with existing educational and community resources.
Interesting Note: The meeting underscored the council's proactive stance on pressing social issues, despite financial constraints, reflecting a strategic approach to long-term community health and welfare. The council meeting focused on several key issues related to social care, health, and family support strategies. The committee reviewed budget monitoring reports, discussed a task and finish group report on child obesity, and considered a new family support strategy aimed at early intervention.
Budget Monitoring Report: The committee received a report indicating a significant overspend in social care budgets, particularly in children and family services. Discussions highlighted the need for an in-house staffing solution to reduce reliance on costly agency staff. The decision to accept the report implies a commitment to addressing these financial challenges through internal workforce development and potentially restructuring services to better manage costs.
Task and Finish Group Report on Child Obesity: The report presented alarming statistics on child obesity and made recommendations for strategic and operational changes to address this. The committee agreed to forward the report to the cabinet for further action. This decision underscores the council's recognition of obesity as a critical public health issue and sets the stage for integrated strategies involving schools, community programs, and infrastructure development to promote healthier lifestyles among children.
Family Support Strategy: A new strategy focusing on early help and intervention was discussed, aiming to streamline support services for families and reduce the need for statutory interventions. The strategy is set to be developed with multi-agency collaboration. Approval of this strategy indicates a shift towards preventive measures in social care, potentially leading to long-term cost savings and improved family welfare.
The meeting was marked by a collaborative approach to addressing complex social issues, with a clear focus on strategic planning and preventive measures.
Attendees
- Cllr. Alex Evans
- Cllr. Alun Lenny
- Cllr. Bryan Davies
- Cllr. Crish Davies
- Cllr. Denise Owen
- Cllr. Fiona Walters
- Cllr. Gareth John
- Cllr. Hefin Jones
- Cllr. Jane Tremlett
- Cllr. Janet Williams
- Cllr. Karen Davies
- Cllr. Louvain Roberts
- Cllr. Meinir James
- Cllr. Michelle Donoghue
- Cllr. Philip Warlow
- Dylan Jones
- Ian Jones
- Jayne Thomas
- Joanna Jones
- Kelvin Barlow
- Lle Gwag
- Martin Runeckles
- Michelle Evans Thomas
- Rachel Morris
- Siwan Rees
- Susannah Nolan
Documents
- Printed minutes 02nd-May-2024 10.00 Health Social Services Scrutiny Committee
- Agenda frontsheet 02nd-May-2024 10.00 Health Social Services Scrutiny Committee agenda
- Public reports pack 02nd-May-2024 10.00 Health Social Services Scrutiny Committee reports pack
- Summary
- Report
- App A-C Revenue Feb 2024
- App D-E Capital Feb 2024
- App F Savings Feb 2024
- Summary
- Summary
- Report
- Summary
- Minutes 21032024 Health Social Services Scrutiny Committee