Agenda item

The Panel will receive an update on this item from the Directors of Adult Social Care & Children & Young People.

The Director of Adult Social Care addressed the Panel, a summary of her briefing is set out below and will be attached as an online appendix to these minutes.

Health and Social Care pressures

The Health and Social Care system remain under significant pressure. South West Ambulance Service NHS Foundation Trust (SWASFT) declared a critical incident on Tuesday 7th September due to the high volume of calls. The Royal United Hospital Trust Bath NHS Foundation Trust (RUH) continues to see increased demand in A&E. Both the Wiltshire and Swindon systems are in a similar position.

The number of Covid patients in RUH remains low but is increasing and this is putting even greater pressure on a system that is already challenged.

Mental Health Services have seen an increase in the referral rates, and this, combined by an inability to recruit into key positions such as, social workers and health staff, is leading to a system that is severely under strain. This is a picture that is being reported across the whole of BSW and indeed nationally.

The Council and Virgin Care continue to work to support RUH and Avon & Wiltshire Mental Health Partnership NHS Trust (AWP) and where appropriate, diverting people to the community who do not require an admission and discharging people from hospital in a timely way.  Staff in hospitals and the community are continuing to work hard to meet increased demand.

Internal Care Homes and Extra Care Service Consultation

The consultation of Care Homes and Extra Care (CRE) staff pay has now closed. The agreement is that all staff who transferred from Sirona will go onto council pay and conditions. They will retain their enhancement, plus an additional increment for staff with 5 years plus service. The new salaries will be paid to staff in the September payroll.

Safeguarding Activity

During 20/21 the Council received 1,115 safeguarding concerns, relating to 838 adults considered to be at risk of abuse or neglect. Despite national concerns at the start of the year that the reporting of safeguarding issues would decrease due to the lack of access to care settings or visits by family or friends to people’s homes, the B&NES referral level only decreased by 27 in comparison with last year.

There has however been a significant increase in the number of referrals received from General Practitioners and other Primary Care staff. Of those who were supported through the safeguarding enquiry process, 67% said that their identified outcome had been fully met, 30% said they were partly met and 2% said their outcomes were not met. The outcomes that remained unmet mostly related to wanting the alleged person sacked or prosecuted, but the employer or police did not feel this was warranted following an investigation.

Councillor Andy Wait asked if the transfer of staff from Sirona had resulted in a financial hit to the Council.

The Director of Adult Social Care replied that the process was carried out within the budget of Adult Social Care.

Councillor Liz Hardman asked if staff working within safeguarding were able to deal with the seriousness of the cases presented to them.

The Director of Adult Social Care replied that all the Social Workers are trained to a level to deal with the cases within their workload. She added that data on this matter is reviewed on a regular basis.

Kevin Burnett asked what appear to be the reasons for continued increase in demand at A&E and are these being addressed.

The Director of Adult Social Care replied that the reasons for demand and related performance at A&E are complex. The numbers of attendance in A&E are showing an upward trend in the numbers of people in A&E over the last 90 days. Age, acuity, complexity, seasonal and structural factors linked to access to other services all play a part in driving up demand in A&E

The Council understanding is that people have delayed or stayed away from primary care over the pandemic and are now becoming unwell or are more seriously unwell due to later diagnosis and missed early care. For example, people have not been able to attend for physiotherapy or remained mobile while staying indoors, as a result they are at higher risk of falls.

The RUH is not back up to full bedded capacity due to covid and the numbers of covid patients continue to increase putting greater pressure on the system.

Workforce remains an issue across the system and due to the lack of skilled staff the pace and flow of discharges is slower than previously.  In addition, as these are now more complex cases the size of packages and amount of help needed is continually increasing.

Kevin Burnett asked what the current OPEL level was.

The Director of Adult Social Care replied that the current OPEL level for Bath & North East Somerset was OPEL 4. She added that the levels range from OPEL 1 which is the system is working well up to OPEL 4 which describes when the system is under the greatest strain and has little or no capacity.  

Kevin Burnett asked if there was any further news from July’s comment around rationalising care home provision and seeing if care homes can help provide care in the community services.

The Director of Adult Social Care replied that currently care homes are not choosing to diversify as between July and now occupancy has risen sharply, and recruitment for Domiciliary Care Providers has become difficult so they are simply struggling to keep their day-to-day business running.

Kevin Burnett asked for an update on Discharge to Assess funding.

The Director of Adult Social Care replied that funding is expected to continue to the end of this financial year; however, we don’t yet know on what scale. She added that further information and guidance was expected shortly.

Kevin Burnett asked if there was any update on the Mental Health White Paper and the impact it will have on B&NES, mentioned in March 21 meeting.

The Director of Adult Social Care replied that the Government have published a paper with the responses to the consultation and that it is on the DHSC website.

Kevin Burnett asked has the Government guidance come through on the Debt Crisis Plan (Breathing Space).

The Director of Adult Social Care replied that the Debt Respite Scheme (sometimes referred to as Breathing Space) guidance has been published and referrals have started to come into the AMHP service under this new act.

The Chairman asked if she was able to comment on the Bladder & Bowel Service provided by Virgin Care as he had been made aware that a number of staff were due to leave and wanted to know whether a restructure would be required and if any interruptions to the service were likely.

The Director of Adult Social Care replied that she would need to take that matter away and discuss with colleagues.

The Director of Children's Services & Education addressed the Panel, a summary of her briefing is set out below and will be attached as an online appendix to these minutes.

SEND

As noted in the Lead Member report, SEND continues to be an increased area of need and demand for services remain high. Whilst our services are responding positively, we are awaiting a long overdue Government review into SEND and the systems, law and practice that local authorities and CCG’s have to adhere too.

Children’s Services

Children’s Services continues to work hard to effectively discharge all Local Authority statutory responsibilities. Demand is high across all services. The workforce continues to work diligently to best support the needs of our local communities.

Children’s Social Care continue to facilitate monthly multi agency meetings, all attendees find this valuable, as it offers an opportunity to understand and address challenges across the system.

Virtual School

As the panel has been previously advised, our virtual school for looked after children had been part of a national pilot to support children in care and children on child protection plans, following DFE funding this extended offer will continue for another 12 months.

Children’s Transformation Programme

A significant Fostering Campaign will be launched across B&NES in September aiming to attract foster carers to B&NES. B&NES now has a dedicated Recruitment Officer for fostering, a marketing apprentice, and have commissioned the services of a marketing agency to support this work- please look out for posters on buses.

Kevin Burnett commented that he was going to ask what the key areas and outcomes are planned for the ‘transformation of Children’s Services’, but then noticed from his previous notes that paper might come to a future Panel. He asked has a date been agreed for doing this.

The Director of Children's Services & Education replied that a date had not been set yet, but she would be very happy to discuss and agree at the next agenda setting and could take a paper in November 2021.

Kevin Burnett asked what the areas of focus and planned outcomes in the Service Improvement Plan are.

The Director of Children's Services & Education replied with the following points.

·  Pre- proceedings

·  Retain a skilled and stable workforce 

·  Participation of parents/carers/ children and young people

·  Data and performance

·  Exploitation

·  More young people are in Education, Employment, and training

·  Disabled Children’s Team

She said that these areas will lead to improved outcomes for Children, Young People and Families.

Kevin Burnett asked if officers had been able to track down the Child Protection Forum’s report which had feedback from schools on frontline services which Lesley Hutchinson was trying to find back in October 2020.

The Director of Children's Services & Education replied that they are trying to source it and will aim to provide it in the near future.

Kevin Burnett asked if she could confirm whether Avon & Somerset Police are now fully implementing ‘Operation Encompass’.

The Director of Children's Services & Education replied that Avon & Somerset Police are not currently signed up formally to Operation Encompass, however they do follow the principles. She said that across all areas, they share the DA notifications with the LA, either via school safeguarding in education teams, or via children’s social care, dependent on the local arrangements.  She added that the LA then check school roll information and share with the appropriate school/college. 

She stated that Avon & Somerset Police are looking at ways that we can automate this process and that we should know shortly whether we have been successful with the joint bid for the Data Acceleration Fund, which B&NES have been a part of. She said that if this is the case, we will be combining LA and Police datasets to send information to schools straightaway.  She added that the intention will be to work in two pilot sites initially – Bridgwater in Somerset, and an area of South Bristol to test the system, but this will be rolled out force wide as soon as possible.

The Chairman commented that he had been pleased to hear that the Council would be involved in bringing Afghan refugee families to live in the area and asked if it was known how many it would be.

The Director of Children's Services & Education replied that it was due to be five families that were to be located in the area. She added that the support from local schools has been welcomed.

The Chairman thanked both Directors for their reports on behalf of the Panel.