Agenda item
Cabinet Member Update
The Cabinet Member will update the Panel on any relevant issues. Panel members may ask questions on the update provided.
Minutes:
Councillor Alison Born, Cabinet Member for Adult Services addressed the Panel and highlighted the following areas from her update. A copy of the update will be attached to these minutes as an online appendix.
ASC Performance
The number of people with current long-term services funded by Adult Social Care is 1,872. In addition to this there are 406 carers with current services funded by Adult Social Care.
There are 48 people currently waiting for a Care Act assessment of their needs, this is an improvement on the previous month of 59. 457 (from the 1,872) are waiting for an annual review of their needs, again this is an improvement trend from 527. The average wait is 8 months overdue, and the longest wait is 11 months overdue. All reviews are risk rated and prioritised accordingly.
Our Mental Health teams continue to experience increased demand, approx. 10% month on month. We have received 104 referrals for detention under the Mental Health Act since April 2023 with 97 of those referrals accepted by the Approved Mental Health professionals.
Finance
Whilst the number of packages provided continued to be below previous levels during the first part of the year, we are now seeing an increase (average of 25%) in year on year activity. Package costs have also increased during the year (average by 12%), due to the economic and market factors that are currently being experienced across the country.
In addition, referrals to the services are increasing in complexity which adds to the budgetary pressure and work continues with health colleagues to review and agree the correct funding model for the services required.
ASC Provider Services Update
The council operates 5 Extra Care Schemes, 3 Care Homes (CRCs) and 1 care agency. The 5 extra care schemes remain rated as good by the CQC and the 3 care homes are rated overall requires improvement but with good in key areas such as caring and safety. Our home care service has yet to be inspected by CQC.
The service has undertaken a comprehensive review of its delivery and costs and will be consulting in October and November on our future plans for the service, a final decision will be made via a Single Member Decision in January 2024. Recruitment to the services continues to improve with our vacancies reducing from 70 to 22 across the services.
Community Catalysts working in B&NES
Strategically, we want to empower people to make their own care and support decisions, as well as ensuring a sustainable, competitive marketplace, with capacity to support the needs of our residents.
To this aim we are working with Community Catalysts as our strategic partner to increase the number of small community enterprises in B&NES that will use their skills and passions to provide a wide range of help and support to local people.
Our recently appointed dedicated B&NES Catalyst is working with three enterprises, supporting them through the development programme, and is engaging with a further ten who have made enquiries. We have recently held two engagement workshops and set up a change group which has membership from statutory and third sector organisations. This is a great start to the project that demonstrates positive interest in this opportunity to ensure that support is community based, builds on strengths, is person-centred, preventative, and affordable.
Specialist Commissioners have been working with social work colleagues and social landlords Curo and Bromford to develop proposals for two new supported living schemes to enable residents to live independently, with support close to their families, friends, and communities.
We are currently out to procurement for a core support provider to provide 24-hour support at these new developments: one at Hygge Park in Keynsham and one at Sulis Down in Bath.
Both schemes will house five individuals with a learning disability and/or autism in their own flats, with space for staff to stay and the individuals to socialise.
We expect the procurement process will conclude later in the autumn and the contract to be in place from January 2024.
Support for Unpaid Carers and Co-production
Unpaid carers play a vital role in enabling people they care for to live with the right care and support at home. We are aware that over the past few years, rates of satisfaction amongst unpaid carers have declined nationally and locally. Our commitment to carers is very strong and we aspire to enable all B&NES carers to feel valued, continue in their caring role if they wish to do so, and to lead their best life.
To this aim we are taking forward two planned pieces of work this year. Firstly, we are preparing for the next national carers survey due to take place in February. This survey will be sent to all carers known to the council to seek a range of quantitative and qualitative information about carers’ experiences and quality of life.
Secondly, we have started planning engagement for a new co-produced carers strategy, which is being developed across the autumn. Together with the B&NES Carers Centre and local carer networks, we will be asking carers what is important to them, what would make a difference and use this insight to inform future commissioning plans for carers’ support.
Kevin Burnett asked if any Council money was involved in the Community Catalysts work or was funding being provided through a third party.
The Assistant Director, Integrated Commissioning replied that the Council was funding the project, but not the delivery of care to individuals. She added that the funding was being provided by last year’s allocation to B&NES of the Better Care Fund. She said that once the Catalysts were operational there would be two funding streams, either through a personal budget, for people who are eligible or directly purchasing the services.
Councillor Liz Hardman asked what the future plans for the Home Care service are and what decision will be taken by the Cabinet Member in January 2024.
The Assistant Director, Operations replied that the service is currently delivered in partnership with the RUH and is due to run until June 2024. She said that the partnership has included the recruitment of international employees and for them to be seconded into work for the Council. She added that in January 2024 they will be seeking options for the service going forward and so the Cabinet Member decision will be based around recruitment and the model of the service.
She stated that they were now looking to stop international employees from joining the service and focus on local recruitment as sponsorship visas only last for three years.
Councillor Hardman commented that it was good to see that waiting times have been reduced for residents waiting for a Care Act Assessment of their needs. She added that however, the average wait time is still eight months and asked can anything more be done to reduce this.
The Assistant Director, Operations replied that the average time is based on all patients and that it might be useful in the future to break these figures down into separate categories as some cases are difficult to assess.
Councillor Paul Crossley asked if any further comment could be given on the numbers involved in the safeguarding enquiries.
The Assistant Director, Operations replied that there has been an increase in referrals, but that the numbers that have required an investigation have been static. She said that the service has been promoted which is why the referrals have increased, but it was important to note that this had not resulted in an increase to people who have been harmed.
Councillor Crossley also raised the escalation of Mental Health cases and asked if it was known what was driving the increase and how our figures compare with other Local Authorities.
The Assistant Director, Operations replied that the figures for B&NES were in line with that of other areas and that across the Avon and Wiltshire Partnership they were seeing an increase in requests for assessments under the Mental Health Act. She said that this did not always translate into detention as they have a robust diversion programme in place. She added she felt that they were still seeing a deterioration in peoples mental health following the Covid pandemic.
Councillor Crossley said that he was concerned about the service having enough resources and asked if the Council was prepared for this in terms of the forthcoming budget.
The Assistant Director, Operations replied that they were currently working on the staffing needs required locally, were within their agreed budget and looking to appoint additional mental health professionals. She added that from April 2024 two additional specialist posts would be in place and that approval had recently been received to recruit four apprentice Occupational Therapists.
Councillor Alison Born commented that they were assessing the resources available in advance of the budget setting process and suggested the Panel have a future agenda item relating to Mental Health provision.
Councillor Joanna Wright asked if an explanation could be given for the figure within the July Cabinet papers that said there was around a £528,000 underspend on Adults and Older People Mental Health & Commissioning.
The Assistant Director, Operations replied that this figure related to the packages of care and that the pressure identified within the update is in relation to staff capacity and their ability to carry out the Mental Health Capacity assessments.
Councillor Alex Beaumont asked if any update could be given on Charlton House.
The Assistant Director, Operations replied that a review of the 3 Care Homes within B&NES has been carried out and that a six week public consultation regarding their future use will begin later in October. She added that Charlton House has continued to make improvements, but only one floor remains in use with a low level of occupancy.
Councillor Wright referred to the New Supported Living Schemes and asked for it to be made sure that these properties are fit for purpose as she had recently received concerns from a number of residents regarding Curo properties. She asked for the Panel to consider receiving a report on Housing at a future meeting.
The Assistant Director - Integrated Commissioning replied that both schemes were to be new build properties and would be built to the expected modern standards. She added that a partnership agreement will be in place between Curo, as a landlord and the care and support provider. She said that the contract award for this was imminent and would provide an oversight of the quality of care and the quality of housing.
Councillor Wright asked who the democratic representative was on the Integrated Care Board. She said that she would appreciate seeing a structure chart of how all the various component bodies interact.
The Director of Place, B&NES, BSW ICB replied that this would be the Chief Executive of the Council, Will Godfrey. She added that a slide deck was available and she would look to circulate that again to the Panel.
The Chair suggested that this alongside a glossary of terms could be included with every update.
Councillor Wright asked how residents can be supported with regard to their understanding of Pension Credits and what they are entitled to receive.
Councillor Alison Born replied that if a resident has had a Social Care Assessment they should be able to receive some direct support and added that they could also contact Age UK / Compassionate Communities Hub for advice.
The Chair of behalf of the Panel thanked Councillor Born for her update.