Agenda item

To present the report of the Head of Adult Services.

The report of the Head of Adult Services setting out the progress made in the last six months against all the improvement areas highlighted by Care Inspectorate Wales (CIW) following its inspection of the Social Services Department in 2022 and subsequent improvement check review in June 2024 was presented for the committee’s consideration and scrutiny.

Councillor Alun Roberts, Portfolio Member for Adult Services, Equality and Community Safety presented the report and he summarised the background saying that the Social Services covering both Children and Families and Adult Services were inspected by CIW in October 2022 as part of its routine Performance Evaluation Inspection. The inspection highlighted areas of strength, good practice and service development with no areas of significant risks or safeguarding matters identified. An improvement check visit conducted by CIW in June 2024 assessed progress on the previously identified areas for improvement and the key findings and evidence are summarised in the report. A Development Plan was created to monitor improvements and the plan and accompanying report were presented to the Corporate Scrutiny Committee in October 2024. The committee requested a further update in six months and this report fulfils that request and includes at Appendix 1 an updated service development plan detailing the progress made in that period against all the improvement areas highlighted by CIW.

The Head of Adult Services confirmed that reports and information had been consistently shared with CIW throughout the process to the Inspectorate’s satisfaction. A final meeting is  scheduled for May to conclude the process.

In acknowledging the positive progress and improvement in the Social Services highlighted in the update report, the committee raised a number of matters in the ensuing  discussion to which  the Portfolio Member for Adult Services, Equality and Community Safety and the Head of Adult Services responded as follows –

·      Questions were asked about the training provided for domiciliary care staff with assurances sought that all staff undergo a comprehensive training programme to equip them to meet clients’ needs thereby ensuring  a positive client experience. Further enquiries were made about the oversight and monitoring of arrangements and service provision.

The committee was informed that CIW has stringent  requirements for staff regulation and has high expectations regarding staff training. Any concerns in this area should be promptly brought to the service’s attention. The Head of Adult Services confirmed that the service actively monitors and reviews the quality of domiciliary care provision which is also subject to external regulation and inspection by CIW.

·      Enquiries were made about waiting lists and whether individuals continue to face delays in receiving care and support.

The committee was advised that waiting lists across all areas have decreased  since the inspection. However, challenges in delivering care remain particularly in relation to staff recruitment, although the staffing position has now stabilised. It was noted that the situation can change depending on factors such as demand, workforce availability, the specific needs of individuals and seasonal variations.

·      Reference was made to advocacy provision and questions were asked about how advocacy services are offered. A further query was raised on whether an average recording percentage of 65% justifies a Green rating.

The committee was advised that the option of advocacy is introduced during the client’s initial contact and is repeated in subsequent interactions or when care packages are reviewed. This ensures that any changes in the client’s circumstances, needs or preferences are considered. Offers of advocacy are documented and records are maintained to monitor access and take-up. While achieving 100% advocacy take-up is challenging due to changing circumstances, a 65% rate is considered a significant achievement. Nonetheless, the service is committed to seeking further improvement in this area.

·      It was noted that the evidence of people’s  voice and choice in assessment and care and support plans is inconsistent. Questions were asked about the arrangements in place to strengthen the voice of service users.

The committee was advised that social workers  have received practice guidance on  recording service users’ voices during assessments and forms have been amended to better capture their perspectives. The importance of engaging service users in discussions about their care via hubs and forums is recognised to ensure their voices are heard. The Portfolio Member for Adult Services, Equality and Community Safety highlighted that to the end of March last year there were 110 positive comments on services received with 19 complaints none of which required formal investigation by an independent investigator.

·      It was noted that Social Services digital case recording will be migrating to a new system and assurance was sought that the introduction of the new system will not result in loss of records or evidence including by service users, and that arrangements are also in place to meet the training needs of system users. Questions were also raised about the 631 safeguarding reports received by Adult Services with a request for greater clarity regarding the outcome of the 236 resulting safeguarding enquiries to provide a fuller picture of safeguarding practice.

The committee was advised that preparation for the national level transfer to a new digital system, supported by the WLGA is underway. Previous migration  to the WCCIS system was completed successfully without data loss and assurance was provided that the new system’s implementation will also safeguard information. Social Care staff have been involved in planning and adapting applications to meet local needs and all staff will receive support to become proficient in the system. The new system is also designed to enable real time service user feedback which can be used to improve services. The new system is expected to go live in 12 to 18 months and an oversight board is monitoring its implementation. In response to further questions about ensuring service user feedback is recorded and evidenced, the committee was informed that feedback mechanisms include formal processes such as complaints and compliments and informal avenues such as  thank you cards or verbal expressions of gratitude. The CIW also gathers user opinions as part of inspections with the Inspectorate having noted the high user response in its review of Anglesey’s Adult Services. The Director of Social Services further clarified that there is ongoing engagement with service users throughout the care process starting with the “What Matters” conversation to identify individual needs and wishes.

The Chief Executive advised that the system transition is a significant change and has been identified as both a risk and an opportunity for Social Services to evaluate current practices, identify improvements and enhance efficiency over the next twelve months.

The Head of Adult Services updated members on safeguarding, reporting that in February this year there were 22 enquiries of which 19 required action. The service keeps comprehensive records on safeguarding including  the number of cases requiring a safeguarding plan and any instances leading to a criminal investigation. Due to the sensitive nature of this information, the service is limited in what it can disclose; however, the committee can be presented with percentage based data.

·      The committee enquired about the steps taken to ensure that reviews of care and support plans are undertaken in a timely manner.

The committee was advised that limitations in social worker capacity and heavy workloads may impact the ability to conduct reviews, with new or urgent cases taking precedence over  long-term, stable cases. Nonetheless, stable cases are regularly monitored though the services provided and a review would be initiated if their circumstances were to change.

·      Reference was made to winter pressures and questions were asked about the social services’ approach to winter pressures and the lessons learnt from past experience.

The committee was advised of the importance of collaborating with partners to address winter pressures and the value of taking a preventative approach to enhance health and wellbeing was highlighted. The service regularly reflects on its  management of winter pressures to identify lessons and improve future responses. Greater funding certainty was highlighted as a crucial factor that could significantly strengthen planning efforts for winter challenges. Responding to further questions about the adequacy of the current Adult Services budget, the Portfolio Member for Adult Services recognised the Authority’s recent investment in adult services which he appreciated. However, he expressed that this investment remains insufficient to address all the challenges the service faces. He emphasised that improved multi-year budgets would allow the service to plan more confidently for the future.

In response to additional questions about unpaid carers the Portfolio Member for Adult Services emphasised that this is a topic of national interest and ongoing discussion. He confirmed meeting with unpaid carers on several occasions including at the Glanhwfa Centre for dementia sufferers and at community hubs which he had found informative. He commended unpaid carers for their invaluable efforts and highlighted the Authority’s commitment to supporting their needs to promote their wellbeing.

Having reviewed and scrutinised the progress made in implementing the post inspection work programme and taking note of the assurances provided by the officers and the Portfolio Member, the Corporate Scrutiny Committee resolved to formally accept the update report.