Agenda and draft minutes

There were no declarations of interest.

Select Committee Public Open Forum ~ Guidance

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No public submissions were received.

To discuss the current challenges faced within the care sector and the Monmouthshire context.

Eve Parkinson delivered the presentation and answered the members’ questions with Tyrone Stokes.

Challenge:

Are there differences between care packages and domiciliary care? Are we working in hand with health authorities or separately?

Predominantly, packages of care and domiciliary care are the same thing. We would assess someone; the majority sits with the local authority unless it’s continuing health care. Following assessment, the package of care is provided either by our in-house domiciliary care services or commissioned providers. In-house tends to be a lot of enablement, reablement and the more complex cases.

Are we partly responsible for bed blocking if we don’t have the staff numbers to do the assessments more quickly?

Our staff go into the hospitals to do the assessments. But it’s following the assessment, whereby it’s decided that that person needs a package of care, we hit a stumbling block where we can’t provide what the assessment has determined. The whole system is very complex. It’s not as simple as someone being admitted to hospital but then we can’t get them out because we haven’t got a package of care. From Welsh Government’s perspective sometimes people shouldn’t have been admitted into hospital – there is a level of risk adversity around admissions – and the evidence is very stark that as soon as someone with several conditions, or who is older, is admitted they deteriorate very quickly. There are people who go into hospital needing nothing, and by the time they are ready for discharge they need a lot of support.

So, at a critical care hospital i.e. The Grange, the assessment will be done when they transfer from there to another hospital, e.g. Nevill Hall?

No, we assess in The Grange as well.

Presumably occupational therapists in hospital do an assessment? Is the Social Services assessment part of that? How does it work in terms of discharge from wards?

It varies across the county: there is a slightly different model at Nevill Hall in that Health Board OTs transfer into our team – so we ‘in reach’ into Nevill Hall, and work with our own people. So, for the most part, our own social workers, OTs and nurses in-reach into the hospital. In the Royal Gwent the model is different. We have a Rehabilitation Support Worker and a Discharge Liaison nurse from our Chepstow team who go into the Gwent to identify people who are from Monmouthshire and bring them out. In our Chepstow and Monnow Vale community hospitals our integrated team works completely.

In the table on p7, there are 104 people with no care at home who are waiting for it. How are they supported in the interim?

It is often family and carers who support them. It is a case of any extra support, respite or day service provision but it is very challenging. If the situation deteriorates, we try to do our best to pull something together, but we don’t have the staff. We have daily conversations with the hospital to ascertain  ...  view the full minutes text for item 3.

Scrutiny of the Housing Support Programme Strategy prior to submission to Welsh Government on 31st March. Report to be accompanied by a Homelessness Update.

Stephen Griffiths presented the report and answered the members’ questions with Ian Bakewell and Rebecca Creswell.

Challenge:

This draft will go to a full draft and then to a full council decision?

Yes, we have permission from Welsh Government for it to be agreed in retrospect (in the new council term, June or July).

Would early intervention operate in association with registered social landlords? How would you identify those at risk, in order to intervene at an early stage?

Identifying households that are experiencing problems that could lead to homelessness is the great challenge. We are looking at ways of data collection and intelligence gathering from many organisations, for example, the vulnerability of households experiencing rent arrears. Those in receipt of local housing allowance will be asked for a Discretionary Housing Payment – that is a flag of a situation that could result in homelessness. If that is flagged to us at an early stage, then we can perform an early intervention to identify needs and the requisite support. We have also contacted every estate agent in Monmouthshire to give them the opportunity to flag up any of their tenants who are beginning to experience low-level risk. We want to link with the Council’s poverty campaign too to encourage anyone experiencing a problem to talk to us.

Is it worth surveying the youngsters and those with complex needs, as to how they ended up in a homeless situation, to assist with prevention?

We are looking at a system to identify those who might become homeless in order to get a housing pathway in place to anticipate possible homelessness.

Is it possible to change the circumstance so that landlords are paid directly out of benefits, rather than by the person in receipt of benefits?

This is harder now because DWP changed the rules relating to universal credit. There is a direct payment arrangement but it’s harder than it used to be.

Regarding prevention, can we compare our picture with other authorities, and collaborate on particular areas of experience?

The previous homeless strategy was a Gwent one but the issues a year ago were so acute that each local authority wanted to focus on its own situation and response, which led to the strategies being individual. But we network very closely with our neighbours – there is a meeting today between the local authorities, for example – which are opportunities for sharing and comparing notes. There is a Gwent scheme to support prison leavers. As things begin to settle down post-Covid joint working will increase further.

There is a lot of pressure on families now from the cost-of-living problem. Perhaps if there is mediation, they wouldn’t need to progress from temporary to permanent accommodation?

We have financial inclusion workers in the housing options team to support people with outgoings and income maximisation. The Housing Support Gateway also does a lot of this work, as does Citizens Advice, so it is a key part of what we do. When trying to find someone  ...  view the full minutes text for item 4.

Scrutiny of the budgetary position (revenue and capital) for services falling within the committee’s remit at Month 9.

Tyrone Stokes and Jonathan Davies presented the report and answered the members’ questions.

Challenge:

How do we forecast the grants that we receive for the overall budget?

It is difficult this year, given the amount of one-off grant funding that we have had. These have come in for a specific purpose, with a particular start and end date. The most recent was just shy of £1.25m to fund overspends in social care, which is why the overspend in adult social care has been almost entirely wiped out from Month 6-9. Other grants are more long-term, such as the Social Care Workforce Sustainability grant, detailed as part of the budget pressures. The short-term grants are welcome but don’t alleviate the long-term pressures that we have.

2021/22 has been very hard. Will things be a bit more normal next year? Could things delivered by grant be noted more clearly, i.e. itemised, in the reports? Why apply for a grant when it means we then have to find the money from elsewhere to continue the service after the grant period expires?

We have a comprehensive central grants register, so we can look at how we feed that into these reports. The Chief Officer’s director’s commentary references the effects on those grants, saying that without those one-off grants the bottom-line position would be £3m worse. Sometimes grants are delivered in such a way that we don’t need to apply for them. It has been more complicated during Covid because the Covid Hardship Fund has propped up a lot of areas throughout the council – moving away from that will present a significant challenge.

Instead of grants, would it not be better to have more core funding?

Yes, that would give us more financial stability. Once a grant goes, we have to decide if we can step down from that expenditure or not, or do we need to meet that expense from core services. It presents a challenge.

What sort of savings have there been, and can we be reassured that they won’t affect services?

We must applaud the service in coping with Covid. Delivering the savings that it has is a significant achievement. We must ensure that there is no effect on the end user. Moving forward, we are responsible when putting savings forward – we aren’t putting any forward for next year, in fact, as the well has run dry on those.

On homelessness, there will be a further grant to September to help with B&Bs but what will happen after that?

As with social care, when the Covid Hardship Fund is removed at the end of this month, there will be a challenge to continue supporting that marketplace moving forward. Once the fund ends there are other avenues for us to explore for homeless funding, from a revenue perspective. It is too early to say whether those will meet all of our pressures for next year. We’ve included headroom of £2m in the capital budget for next year, put forward as  ...  view the full minutes text for item 5.

The minutes were confirmed and signed as an accurate record, proposed by Councillor Brown and seconded by Councillor Edwards.

Things will change somewhat if/when the new committee structure is agreed. The Gypsy and Travellers site issue needs to stay on the agenda; this piece of work is ongoing.

It will be in June but is to be determined specifically once the Council’s new diary is approved.