Agenda item

Jane Rodgers introduced the report and answered the members’ questions with Jenny Jenkins:

 

The social care budget appears broadly balanced overall, but this masks a children's services overspend and an adult services underspend. Can assurance be provided that the adult services underspend reflects genuine management of demand rather than unmet need or staffing constraints?

 

The Adults services underspend was supported by late-year grant funding, particularly funding intended to support hospital discharges and community-based care. These grants were used to offset core care costs, including residential care and care-at-home provision. Officers stated that the underspend did not result from unmet need or reduced service provision, but reflected the availability of additional grant funding that helped manage expenditure while continuing to meet people's care and support needs.

 

What measurable benefits are expected from the Council's investment in developing in-house residential and fostering provision? How many children are currently in external placements, what are the associated costs, and can it be demonstrated that in-house provision delivers savings once staffing, property and support costs are taken into account?

 

Developing in-house provision is helping to reduce reliance on external placements while also improving outcomes for children. During the year, the Council opened a residential children's home in Monmouthshire and developed additional bespoke placements. At the end of the reporting year, seven children were living in in-house residential provision, increasing to eight by the time of the meeting. The Council also had four young people in supported accommodation provision, with plans to open a further children's home and another supported accommodation facility during the current year.

 

External residential placements can vary significantly in cost, ranging from around £4,000 to £4,500 per week at the lower end to £15,000 to £17,000 per week for children with the most complex needs. The Council's in-house provision has delivered the savings anticipated in the original business cases and provides better outcomes for children while contributing to the service's savings targets.

 

In addition to residential provision, the Council has invested in strengthening its in-house fostering service by improving the financial support and wider offer available to foster carers. Officers reported that the authority had achieved a clearer distinction between children placed with its own foster carers and those placed through independent fostering agencies, resulting in both financial benefits and improved placement stability. The contribution of in-house foster carers was highlighted as a significant factor in reducing costs and increasing capacity within the service.

 

The Member welcomed the explanation and noted the importance of evidence that in-house provision is delivering positive outcomes for children and young people as well as value for money.

 

The fostering element of the strategy is equally important as the residential provision programme and highlighted the progress made in increasing the use of in-house foster placements, which has reduced reliance on more expensive independent agency placements while helping to achieve better outcomes for children.

 

The report indicates that external residential placements can cost between £200,000 and £800,000 per child per year. How many in-house children's homes does the Council now operate, and how does that compare with the number of externally managed children's homes operating within the county?

 

The Council currently has three registered in-house children's homes and is expecting to open a fourth during the current year. In addition, there is one supported accommodation provision currently operating, with a further provision due to open this year and another planned for the following year. This would eventually provide three supported accommodation schemes alongside four children's homes.

 

(Officers could not provide the exact number of externally managed children's homes in the county during the meeting but will provide the precise figure separately. – ACTION: to provide the exact figure)

 

How many of Monmouthshire's looked-after children are placed in externally managed residential homes within the county, and how many are placed outside the county? Given the growth of local in-house provision, it would be useful to understand how many children are still in externally provided placements nearby.

 

The existence of many externally operated children's homes within Monmouthshire does not mean that they are occupied by Monmouthshire children. Many of the Council's children placed in external provision are located outside the county, while children from other authorities are often placed within Monmouthshire because of its location close to the England-Wales border. Securing external placements remains highly competitive.

 

(The precise breakdown of placements within and outside the county was not available at the meeting but this information will be provided afterwards. – ACTION: to provide the exact figures)

 

Only 57% of care leavers are in education, employment or training. What support is available for the remaining 43%, how many young people does that represent, and what is being done to address the higher risks of isolation and poor outcomes experienced by care leavers?

 

The 43% figure relates to a relatively small cohort, although the exact number was not available at the meeting and was to be provided later. A significant proportion of those not in education, employment or training are unaccompanied asylum-seeking young people whose immigration status means they do not yet have the right to work. Others may not be ready for employment or education because of their personal circumstances, may be parents themselves, or may be affected by benefit-related issues linked to their accommodation arrangements.

 

Every care leaver has access to a Personal Adviser and receives ongoing support to plan their transition into adulthood. Efforts focus on helping young people build support networks, maintain connections with services, access peer support, and develop pathways into education, training or employment. Support can continue until the age of 24 or 25, helping to reduce isolation and provide a consistent source of assistance when needed.

 

The complaints table is difficult to understand, particularly the outcome column. What do terms such as "upheld", "not upheld" and combinations of different outcomes mean, and what learning has been taken from complaints about financial assessments, charging, care planning and communication?

 

The outcome column records the findings of independent investigators who review Stage 2 complaints. "Upheld" means the complaint was found to be valid, "not upheld" means the evidence did not support the complaint, and "partially upheld" means some aspects were supported while others were not. Some complaints contain multiple elements and sub-elements, which is why several different outcomes can appear against a single complaint. It was acknowledged that the presentation could be made clearer for readers.

 

Complaints are used as a source of learning for both individual practitioners and wider services. Where recurring themes emerge, such as concerns about financial assessments and charging arrangements, additional staff training and guidance are introduced. A large proportion of complaints relate to communication, particularly where complex care processes and legal requirements need to be explained to families who are often under considerable stress. Ongoing professional development, supervision and training are used to help staff communicate more clearly and ensure families understand the decisions being made, their options, and the support available to them.

 

The outcome table contains entries showing combinations of upheld and not upheld findings for the same complaint. Why is this so complicated?

 

Some complaints are broken down into a number of separate allegations and sub-allegations. Investigators assess each element individually, meaning one part of a complaint may be upheld while another is not. This can produce a series of mixed outcomes that appear confusing when viewed in summary form without the full investigation report. It was acknowledged that a more consolidated presentation could improve readability in future reports.

 

Why do some people receive the social care survey while others do not, and how is the survey sample selected?

 

The survey follows a Welsh Government methodology and is sent to a specific cohort of people who meet defined criteria, enabling results to be compared consistently across Wales. The exact selection criteria are determined nationally rather than locally. The survey process runs continuously throughout the year. Approximately one-twelfth of people who have an active care and support plan are selected each month, subject to a number of filters. For example, people who have asked not to be contacted are excluded. This rolling approach means feedback is gathered throughout the year rather than through a single annual exercise. Anyone with concerns about their care or support can contact the service directly rather than waiting for a survey.

 

Could the criteria used to select survey recipients be shared with members?

The request was noted, and it was confirmed that the survey operates according to specific national criteria and filtering arrangements. – ACTION

 

For unaccompanied asylum-seeking children who become care leavers and may not have the right to work or access benefits, what ongoing responsibilities does the Council have towards them? Are language barriers a significant issue, and what support is available to help them?

 

The Council continues to have responsibilities towards unaccompanied asylum-seeking young people when they become care leavers. Support remains in place until their immigration and asylum status is resolved, and the Council has an ongoing duty to ensure they have access to accommodation and appropriate support. Young people are connected to language support, legal advice relating to their immigration status, and culturally appropriate services while they are in care and as they move into care-leaver status. Experience built up over a number of years has enabled the service to provide ongoing support tailored to the needs of unaccompanied asylum-seeking children and young people.

 

The service remains involved throughout this period to help ensure they are supported until their circumstances are resolved.

 

What are the current levels of vacancies and sickness absence within social care services, are these a cause for concern, and are they improving or worsening over time?

 

Vacancies remain a challenge across both adults' and children's services, with around 30 vacancies typically existing at any one time. In adults' services, the workforce is large, with over 400 full-time equivalent staff, and some turnover is inevitable because of retirements, career progression and people moving jobs. Recruitment has improved over the last 18 months, particularly within direct care services, although vacancies remain within reablement services.

 

Vacancies can affect the ability to provide services at the right time and can place additional pressure on existing staff. In statutory services, where individuals must have an allocated social worker, agency workers are used where necessary to maintain required staffing levels. Recruitment remains difficult in some specialist areas, particularly child protection social work.

 

Turnover in children's services is around 10%, which was described as comparatively positive for a service of that nature. Turnover is slightly higher within adults' services. Recruitment is supported through targeted campaigns, training opportunities, student placements and efforts to promote social care as a career.

 

Sickness absence is actively monitored through an individualised approach that focuses on supporting staff back into work and maintaining regular contact. Managers receive detailed information on both long-term and short-term sickness absence, which helps them respond appropriately. Some sickness absence reflects the nature of social care work and the age profile of parts of the workforce. While sickness levels remain a challenge, they are managed proactively through support, supervision and workforce management processes.

 

What impact could the proposed Gwent-wide Social Care Workforce Development Service have on the issues raised through complaints and on workforce learning and development more generally?

 

Learning from complaints is primarily delivered within social care services themselves through line management, supervision, team support and professional development arrangements. The way complaints are reviewed and used to improve practice is embedded within day-to-day service management and is not dependent on the workforce development team.

 

The workforce development team has a more specific role focused on supporting student placements and delivering the formal training programme funded through the Social Care Wales Workforce Development Grant. This includes statutory and professional training, some of which can be tailored to local service needs, and training is often shared with neighbouring local authorities.

 

The deeper professional learning that comes from individual cases, complaints, supervision and service experience remains the responsibility of managers and teams within the service itself. As a result, learning from complaints and the ongoing development of practitioners is expected to continue through existing service management and supervision arrangements.

 

If the proposed move to a Gwent-wide Social Care Workforce Development Team goes ahead, how can it be ensured that the close relationships, local knowledge and support currently provided to Monmouthshire staff, student social workers and foster carers are maintained?

 

The Workforce Development Team plays a vital role in supporting student placements, newly qualified social workers, professional training and workforce development across social care services. It also provides more tailored support to help services implement changes and new ways of working.

 

The proposal seeks to balance the benefits of a larger, more resilient regional service with the need to retain strong local connections. A regional arrangement could reduce duplication, improve resilience, strengthen links with universities and provide greater capacity for commissioning training. At the same time, the proposed business partnership model is intended to ensure that Monmouthshire retains dedicated links into the service so that local workforce needs, service changes and training requirements continue to receive direct support.

 

The aim is to retain the benefits of local responsiveness while gaining the advantages of a larger shared service.

 

What does the new "START" reablement model look like, what progress has been made in implementing it, and how are external care providers being supported to work within this approach?

 

The START model places reablement support at the beginning of the care pathway, enabling people to receive assessment and intervention as soon as they enter the system. Reablement workers have been trained and upskilled to undertake functional assessments, reducing reliance on social workers for every initial assessment and helping people access support more quickly.

 

This approach has increased the number of people receiving reablement services and reduced waiting times for assessment. Reablement staff now undertake assessments, work closely with social workers and support more responsive decision-making about care needs.

 

A programme of therapist-led training and competency development has been delivered to support staff. Work is also underway with external care providers through a "trusted assessor" approach, enabling providers to share information more effectively and alert the Council more quickly when a person's care needs increase or decrease.

 

The longer-term aim is to create a more outcome-focused model of assessment and commissioning across the whole system. While further development is still needed, significant progress has already been made in embedding the START approach and improving responsiveness for residents.

 

Chair’s Summary:

 

The Chair thanked the Chief Officer for the excellent report, in content and accessibility; the inclusion of Case Studies, as previously requested, was gratefully noted. He expressed the Members’ thanks for the hard work from officers and associated teams. He noted that it would be helpful for the directorate to reflect on whether AI could play a role in improving outcomes for service users, increasing efficiency, or supporting the delivery of social care services, and potentially develop this issue further in future reporting. The report was moved.