Agenda item

To submit a report by the Director of Social Services.

Submitted – a report by the Director of Social Services on the Social Services Monitoring Arrangements.

The Director of Social Services gave a presentation to the Committee and highlighted the role of the Contracting Team, which at present has 3 Officers, carrying out the work so as to:-

·           Ensure contracts meet legislative and statutory requirements;

·           Operate a framework for robust contract monitoring, ensuring performance of contracts is monitored against specifications;

·           Ensure systematic monitoring and review of residential and nursing home services, community living services, domiciliary and day services within Anglesey and out of county providers.

The Director of Social Services referred to the monitoring procedure by the Contracting Team as follows:-

Domiciliary Care - Annual announced site visits (looking at Service User files and staff files, policies, accident and incident book, record of complaints and MAR sheets;

Residential/Nursing Care – Joint announced site visit with BCUHB (looking at Service User files and staff files, policies, accident and incident book, record of complaints and MAR sheets.  Interaction with residents and observations of practises within the Home;

Fostering – Commissioning Consortium Cymru (4Cs) which has a monitoring team working as part of this consortium;

Residential children’s – Desk top monitoring, 4Cs.

Supported Living – Annual announced site visit – looking at Service User files and staff files, policies, accident and incident book, record of complaints and MAR sheets;

Day Services – Currently full site visit and audit of all relevant policies and risk assessments.

He said that significant improvements have been made within Residential Care Homes in terms of achieving and evidencing the 9 specific outcomes noted within the monitoring framework.  As regards to Domiciliary Care a contract model enables providers to better manage costs through efficiencies in service delivery, providing a more localised service and improving recruitment and retention.  Children Fostering/Residential – live placement referrals and tendering process, using CCSR to shortlist the providers who are relevant to the child’s needs.  Providers increase the visibility of their offerings each time a child requires a placement.

The Committee considered the report and raised the following matters:-

·           Clarification was sought as to whether the Local Authority’s Care Homes are monitored in the same way as private Care Homes.  The Director of Social Services responded that the Local Authority’s Care Homes are monitored in exactly the same way;

·           Questions were raised as to whether there is sufficient staff to carry out the monitoring of the services to the best standards possible.  The Director of Social Services responded that the Contracts Team has been increased in the last year to 3 and he considered that the team is monitoring the services to an acceptable level.  He referred to the monitoring of risks and noted that consideration will be given as to whether there is a need for visits as frequently if the Local Authority is confident that the service providers are performing to a high standard.  However, if there are concerns the Contracts Team can carry out more frequent visits.  Where residents from Anglesey are located in Care Homes that are out of county it is that local authority that will carry out the monitoring procedures;

·           Clarification was sought as to the procedure when families have concerns as to the service provided by Care Homes.  The Director of Social Services responded that complaints should be voiced to the Care Home in the first instance.  However, if concerns still exist the complainant needs to contact the Local Authority and to CIW.  The Local Authority will contact the provider to ascertain the complainants concerns and if the matter is a safeguarding issue consideration will be given to the evidence of neglect and whether there is a need for the matter to be referred to the Police;

·           Questions were raised as to whether the Contracts Team ask the views of clients at Care Homes when visits are undertaken.  The Contracts Manager said that discussions are undertaken with clients but sometimes the clients are in poor health and do not necessarily understand the questions asked of them as regards to the care provided. Families are asked to fill in a questionnaire to ascertain their experiences as to the service provided at the Care Homes;

·           Clarification was sought whether Contract Team monitor the facilities at Hafan Cefni and Penuchedre.  The Director of Social Services responded that the Home Care provision is monitored at both these locations.  He noted that the housing agency Pennaf are responsible for standards of the accommodation provided; 

·           Questions were raised as to why Day Care Centres are not monitored by the CIW.  The Contracts Manager responded that Day Care Centres are not registered establishments at present and hence they are not inspected but Day Care Centres are reviewed through the Social Services Contracts Department to make sure that the services provided are of a high standard;

·           Reference was made that some of the outcome performance table is showing as red as regards to some services provided.  The Director of Social Services responded that this shows that some of the Care Homes in 2015 were not delivering care to the expected standards at that particular time but due to monitoring procedures put in place these Care Homes are now out of the red area.  The Contracts Manager noted that where a Care Homes was failing the expected standards an improvement plan was put in place.  A Member asked as to whether the Contracts Team carried out visits during the night and weekends.  The Contracts Manager responded that a Team Member has been visiting unannounced during dinner time to monitor whether patients are helped to eat and visits have been undertaken during the evenings and weekends aswell where considered necessary;

·           Reference was made that it seemed that there is a high level of turnover of staff within Care Homes and it can result in training and good practise within the Homes being below what is expected.   The Contracts Manager responded that some Care Homes experience high volumes of turnover of staff with staff moving from one Care Home to another.  Training procedures can become an issue at these times.  The Director of Social Services said that the Care Sector needs to attract more people into the sector and should in his view have a ‘one-pay’ structure across the care sector.

It was RESOLVED to note the report and that an Annual Report on the Social Services Monitoring Arrangements be submitted to the Partnership and Regeneration Scrutiny Committee.

ACTION : As noted above.