Venue: County Hall, Worcester
Contact: Emma James /Jo Weston Overview & Scrutiny Officers
Apologies and Welcome
The Chairman welcomed everyone to the meeting, in particular those representing Worcestershire Association of Carers.
Apologies had been received from Cllrs Rob Adams and Andy Fry.
The Chairman explained that she would need to leave the meeting at 3.30pm due to an urgent appointment, at which point the Vice-Chairman would take over.
Declarations of Interest
The Chairman declared a disclosable interest in relation to Item 5 (Support for Carers), as she was a member of Worcestershire Association for Carers.
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 24 September 2019). Enquiries can be made through the telephone number/email address below.
Confirmation of the Minutes of the Previous Meeting
The Minutes of the meeting on 11 July 2019 were agreed as a correct record and signed by the Chairman.
In attendance for this item were:
Worcestershire County Council Directorate of Adult Services
Avril Wilson, Interim Director of Adult Services
Elaine Carolan, Assistant Director - Strategic Commissioning
Sarah Rothwell, Commissioning Manager
Worcestershire Association of Carers
Carole Cumino, Chief Executive
Mel Smith, Integrated Carers Hub Manager
Carers – Anne Duddington and Sandra Rohan-Kickham
The Council’s Assistant Director for Strategic Commissioning had prepared a presentation and was invited to highlight the key points, after which the Panel was keen to hear from Worcestershire Association of Carers and also from the carers present.
The presentation included definitions of a carer, the rationale and key elements of the Integrated Carers Hub, types of support provided, carer assessments, the ‘Working for Carers’ employer accreditation and how Overview and Scrutiny could help.
A carer was defined as ‘anyone, including children and adults who looks after a family member or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid.’
In Worcestershire there were significant numbers of carers; 63,685 adults and 3,490 young carers.
The Integrated Carers Hub was a really brilliant development for Worcestershire and had only been possible due to the openness of Worcestershire Association of Carers (WAC). The Hub acted as a one-stop shop and effective marketing was very important, as carers did not always know what help was available.
The principles behind carer assessments were recognising carers as the experts in their own lives, therefore practitioners needed to understand the neighbourhoods and communities in which people lived and have clear language. Assessments took a holistic approach to looking at how to sustain the carer and their ability to care.
Key elements of the delivery of the Hub included specific support, for example end of life, peer support for carers to understand their value, marketing and awareness raising to break down isolation, employment, education, training, carer training, befriending, a talk line and volunteering opportunities.
Worcestershire’s increasing ageing population and increasing average life expectancy presented a problem as many people would live longer but in poor health. A further challenge was the increasing number of older carers for those with learning disabilities.
The Council was now signed up to ‘Working for Carers’, to become an accredited employer, since it was clearly important for the Council to recognise the caring responsibilities of its own staff.
There was a role for Scrutiny to help by:
· getting the message out to raise awareness
· encouraging people to identify themselves as carers, for example whilst visiting their GP
· raising the profile of carers, whose support saved a staggering amount for Adult Services
· promoting understanding of the impact of carers on the Worcestershire economy and cost in the workplace.
The Chairman invited questions and the following main points were made:
The Panel Chairman said that members would of course want to assist in signposting constituents and highlighted that some scrutiny work was due to take place to look at care ... view the full minutes text for item 330.
(The Chairman left the meeting and the Vice-Chairman chaired the rest of the meeting)
Financial Information (Period 4 2019/20)
The Head of Finance explained that period 4 information had been made available to the Panel, which was due to be considered by Cabinet. The Adult Services budget was forecasting an end of year overspend of £3.3m, which was 2.4% of the c£136m Adult Social care budget and the Agenda included a graph to indicate areas of under and overspend, as well as the reasons for the most significant variances. The main reasons for overspend related to Older people’s Residential and Nursing Care activity and one off pressures from the opening of The Burrows (Supported Living Scheme) and redundancy costs.
It was explained that in relation to Older people Residential and Nursing Services budget was not due to greater numbers of people, but an increased unit cost due to inflation, minimum wage, recruitment and retention issues.
The Directorate had a savings programme of just under £9m, which was pleasing to note, was mostly on target. The Directorate was also looking at ways to mitigate the £2.4m recurrent cost pressures.
At this point in time, the Head of Finance did not anticipate any dramatic changes to figures for period 5, although it was clarified that not everything could be anticipated.
It was clarified that the 108% increase in Support Services was income from clients and working better to collect income owed.
It was clarified that the 43% underspend in the Integrated Commissioning Unit budget was due to successive rounds of staff reductions within the Unit.
A Panel member asked whether there were any other approaches to tackling cost pressures which could be tried and the Head of Finance said that the Directorate was quite good at predicting numbers but could be better at predicting market direction. A number of proposals were being developed, including a proposal to increase community reablement which would not change unit costs but would reduce numbers of people going into residential care.
The Director of Adult Services spoke about the outcomes of a review of cases to understand why people were placed into care, and it was known that in 2 out of 5 cases the individuals were coming from health settings. It was important to try and ensure that someone coming into the system as a relatively simple case should then be going home as a relatively simple case. More work was needed to try and reach self-funded people at an earlier stage to encourage them to plan for the future.
The Assistant Director spoke about problems with staff vacancies in nursing homes, and homes closing due to high agency costs. Worcestershire was an attractive place to build luxury care homes, but there were insufficient staff. Therefore, applications for care homes were regularly turned down and there were ongoing conversations with district colleagues. It was also an issue for Worcestershire when people moved from other areas to care homes, and then required funded placements when they ran ... view the full minutes text for item 331.
The Scrutiny Officers would give thought to looking at assessments for Continuing Healthcare, which had been put forward during the Panel’s discussion on support for carers.