The Scrutiny Performance Panel for Adult Services met on Tuesday 28 January 2025 to discuss performance monitoring, adult services improvement programmes, and the work plan. Key discussions included the positive impact of the reorganised common access point, ongoing challenges with social care reviews, and the need for enhanced step-down provision from hospitals. The panel also agreed to undertake visits to various adult services to gain a better understanding of frontline operations.

Performance Monitoring

Lucy Friday, the interim head of adult services and tackling poverty, presented an update on performance monitoring, highlighting improvements in the common access point (CAP) following a restructure in September 2024. The CAP, which serves as the primary point of contact for adult services, has seen a reduction in overall demand and an increase in calls answered by the front door, indicating that the right demand is being directed to the service. A significant achievement noted was that 54% of all demand into the CAP was supported without the need for referral to social work teams. The number of tasks created, representing referrals to social work teams, has decreased, suggesting that individuals already known to the service are being directed to their named social workers more effectively. Rapid response numbers have also declined, indicating more timely management of demand and prevention of escalation.

Regarding social work assessments and reviews, the panel was informed that waiting lists for initial assessments have begun to reduce, leading to more timely responses for new service users. There is also a greater exploration of alternatives to traditional managed care routes during the assessment phase. However, reviews and reassessments remain an area of close monitoring. While the number of completed reviews has been static, the panel noted that a significant percentage of social care reviews were overdue. Lucy Friday explained that this was partly due to a more flexible and responsive approach to reviews, where some are brought forward if there is a timely need, even if not a full 12 months since the last review. This responsiveness, while beneficial for individuals, has impacted the achievement of statutory annual review targets. The panel also discussed the concept of bridging, which occurs when there is a gap between a client leaving reablement services and starting with an external provider. This is seen as an area for improvement, as it takes up capacity that could be used for new clients.

Concerns were raised about the backlog in the DOLS (Deprivation of Liberty Safeguards) team, with assurance given that a new model, used in other parts of the UK, would be rolled out to address this. The report also highlighted consistent safeguarding demand, with an increase in Public Protection Notices (PPNs) and professional concerns.

Councillor Cheryl Philpott raised a point of order regarding a public letter that was discussed, questioning whether it was appropriate to share a letter that appeared to be a specific complaint rather than a general query. Amy Hawkins, interim director of social services, stated that the letter did not identify any particular person and that the cabinet member would provide a response.

Councillor Paxton Hood-Williams asked about the absence of figures relating to prevented hospital discharges, which was acknowledged as a gap that would be addressed in future reports. Questions were also raised from the Regeneration panel concerning red-level risks related to safeguarding disabled facilities grants and connecting care, and the performance indicators for care and support plan reviews.

Adult Services Transformation Programme

Councillor Louise Gibbard, Councillor Champion for Children and Family Services, Pensions, Safeguarding, and Women, presented the Adult Services Transformation Programme, highlighting significant progress in improving care services to enable people to live well and independently in their communities. The programme is structured around three priorities: prevention, promoting independence, and prioritising resources.

Under prevention, efforts have focused on reorganising the common access point (CAP), integrating an early help worker, and incorporating sensory support services to assist individuals with sensory impairments. This has led to positive outcomes, with 54% of CAP inquiries in November 2024 resulting in no ongoing referral to social work, and a decrease in the need for social work assessments. A wellbeing officer pilot showed that 13% of individuals awaiting assessment no longer required one after engaging with community-based support.

Promoting independence involves enhancing reablement services and pathways. The home care reablement service and step-down beds at T Westfield are performing well. Referrals for assistive technology have increased by 33%, supporting independent living. The reorganisation of assessment and care management teams has focused on clear contact points and reduced process steps. Externally commissioned domiciliary care is being optimised, with a focus on new care models and regional collaboration to improve the use of pooled funds and rationalise specialist equipment provision.

Looking ahead to 2025-26, the programme will continue to be refreshed and monitored by the adult services continuous improvement group and transformation boards.

Councillor Paxton Hood-Williams inquired about the impact of the Dementia Hub and the growing demand for dementia services. Louise Gibbard noted the significant impact of dementia, highlighting the eight beds at T Westfield specifically for dementia clients and the positive outcomes achieved. The population needs assessment also indicates a growth in the dementia demographic.

Councillor Cheryl Philpott raised concerns about hospital bed blocking and the need for increased step-down provision. She questioned the closure of community hospitals and convalescent homes, suggesting a pooling of funds with the health service to provide more beds. Amy Hawkins, interim director of social services, confirmed that there is significant work happening in this space, with a 50-day challenge from the minister to improve hospital discharges. She acknowledged the complexity of the issue, citing reasons such as the need for equipment in the home or additional reablement support.

Councillor Tony Beddow raised a comprehensive set of factors considered when assessing individuals in need, including gender, age, illness, relationships, prognosis, assets, domestic situation, carers, and friends. Louise Gibbard and Amy Hawkins confirmed that the transformation programme aims to place greater emphasis on building community connections and resilience through prevention and early help, referencing the local area coordination network.

Adult Services Work Plan

The panel discussed the Adult Services Work Plan for 2024-25. A proposal was put forward by the Chair, Councillor Susan Jones, to undertake visits to various adult services on the ground to gain a practical understanding of service delivery beyond data. This was met with broad support from the panel, including Councillor Mark Tribe, who saw it as an opportunity for a critical friend approach. Councillor Victoria Holland expressed a concern about overwhelming services that are already under pressure, but the consensus was that visits would be conducted with adequate notice and in small groups to avoid undue burden. Councillor Jeff Jones raised a question about the criteria for home carers and how their capacity is measured, which was noted as a point for future discussion. Councillor Paxton Hood-Williams recalled better cooperation between the health board and the council during the COVID-19 pandemic