Venue: County Hall, Worcester
Contact: Emma James /Jo Weston Overview & Scrutiny Officers
Apologies and Welcome
Apologies had been received from Mr P Grove.
The Chairman welcomed everyone to the meeting, including Members from the Health Overview and Scrutiny Committee (HOSC) who had been invited to participate in the joint discussion of reviewing the budget position for Adult Services and Public Health.
Declarations of Interest
Members of the public wishing to take part should notify the Head of Legal and Democratic Services, in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 5 November 2018). Enquiries can be made through the telephone number/email address below.
Mrs Anne Duddington, a Parent Carer of an adult with learning disabilities, read out a statement to the Panel.
In summary, Mrs Duddington raised three points:
- The importance of co-production when discussing future services to share experiences and establish how any change would impact on lives and how everyone can work together to find pragmatic solutions
- Carers were extremely concerned to read that the number of Learning Disability Partnership Board meetings would be cut in half from 6 to 3 a year and that most of the sub groups would also be cut
- The above does not fulfil the principle of co-production as defined in the Care Act 2014.
The Chairman thanked Mrs Duddington for her participation and promised a written response.
Confirmation of the Minutes of the Previous Meeting
The Minutes of the Meeting held on 12 September 2018 were agreed as a correct record and signed by the Chairman.
By way of introduction, the Director of Adult Services highlighted some facts from the previously circulated presentation, mainly:
· At the end of Period 5 (end of August) there was a £15.2m overspend out of £125.4m net service Budget. Additional savings had been identified to reduce the overspend to £14.3m
· The population of Worcestershire was 583,491. 77,377 were aged 65-74 and 56,678 were over 75, meaning that nearly one in four were over 65
· The Council's 2018/19 budget for Adult Social Care was £187.671m
· £97.036m was spend relating to older people and £60.083m was spend relating to adults with a learning disability
· Increasing numbers of adults were requiring care, not only due to an ageing population but also due to people who had previously funded their own care becoming eligible for care due to depleting resources and young adults with disabilities whose own parents were becoming infirm
· Costs were increasing, ranging from market forces such as the national minimum wage and fuel costs, to adults living longer with more complex needs and requiring more intensive care
· It was important to better forecast demand and capacity, set out key priorities and work with the market to provide a position statement.
In the ensuing discussion, the following main points were raised:
· Whilst Members understood the current position and the continual shift towards promoting independence, they were keen to know what any changes would mean to residents. In response, it was suggested that whilst making savings, every effort would be made to protect front line services. However, as a result, back office changes may result in response times being slower
· The new model of social work (3 Conversation Model), had already seen some success and there would be a shift in collective community based services providing a greater offer than at present. In addition, increased information advice and guidance would be available as self-help tools
· The Panel was delighted to note additional central Government funding, however, agreed that a long term national solution was required
· In relation to staff morale, it was reported that there was some nervousness in back office functions, but it was important to have honest discussions with those affected. Morale was good in the locality teams and learning disability teams
· Everyone agreed that the population needed to focus on prevention, to stay healthy and independent for longer. It was reported that there was a good take up of NHS Health Checks in the County, designed for those aged 40 to 74 to identify early signs of conditions such as diabetes, stroke, heart or kidney disease. However, there was a drop in childhood immunisations, such as measles, which was a cause of learning disability
· A Member asked about the benefit of assistive technology to be informed that this was a fast growing market. The Director added that the next development would be the use of the data from the technology, such as knowing that a person is dehydrated and alerting them to have a drink. When asked whether technology saved money, ... view the full minutes text for item 296.
The Director of Adult Services had provided an overview of Adult Services absence as part of the Agenda and highlighted the following points:
· County Council recruitment in adult social care was less problematic than in children's services, however, external Providers continued to report their difficulties
· Providers currently had 130 vacancies for nursing or social care assistants across the County. Reasons cited included challenging circumstances, a low wage, the suggestion that caring as a profession was not attractive and more recently the uncertainty over EU workers being able to stay after Brexit
· There was concern that generally, the age profile of the workforce was older
· Nursing was now a graduate profession
· In response to a question about the Council promoting a career in caring, the Director highlighted the Council's social work academy, the opportunity to study for a degree and the corporate adverts that promote Worcestershire as a beautiful place to live and work
· Members asked about levels of pay, to be informed that the national living wage was rising each year, however, nationally the sector was not well paid
· The Director suggested that to overcome some of the challenges, there needed to be a societal change and promote that a career in care is valued with the opportunity to change someone's life
· The Cabinet Member added that the care industry in the County employed over 15,000 people.
In relation to absence rates across the Directorate of Adult Services, it was acknowledged that the reported average 14.43 days of absence per person during 2017/18, was considerably higher than every other Directorate, with the County Council average being 8.71 days.
In a general discussion, the following key areas were noted:
· The Director suggested that those working in social care would perhaps be more susceptible to neck and back injuries and that it was important to establish whether everyone was undertaking manual handling correctly and organise training if required
· In response to a question about the level of support available to employees, the Director stated that a new Attendance Policy had been recently introduced, which included the types of support available to colleagues, including occupational health
· Managers needed to understand the issues and respond accordingly, especially as Stress was another key reason for absence. Return to Work interviews were carried out and sometimes exit interviews were undertaken
· When asked about the impact on services due to absence, the Director stated that there should always be sufficient staff to cover the service
· The Panel requested further information on the reasons for absence and the new Attendance Policy.